Alcohol use disorder and liver transplant: new perspectives and critical issues
| Autor: | Stefano Gitto, Silvia Aspite, Lucia Golfieri, Fabio Caputo, Francesco Vizzutti, Silvana Grandi, Valentino Patussi, Fabio Marra |
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| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: | |
| Zdroj: | The Korean Journal of Internal Medicine, Vol 35, Iss 4, Pp 797-810 (2020) |
| Druh dokumentu: | article |
| ISSN: | 1226-3303 2005-6648 |
| DOI: | 10.3904/kjim.2019.409 |
| Popis: | Alcoholic liver disease is a consolidated indication for liver transplantation, but many unsolved issues can be highlighted. Patients with alcohol use disorder develop peculiar comorbidities that can become contraindications for transplantation. Moreover, a number of social and psychological patterns should be evaluated to select candidates with a low risk of alcohol relapse and adequate post-transplant adherence. In this context, the 6-month rule is too rigid to be widely applied. A short period of abstinence (1 to 3 months) is useful to estimate recovery of liver function and, possibly to avoid transplant. Cardiovascular disorders and extra-hepatic malignancies represent the main clinical issues after transplant. Patients transplanted due to alcoholic disease are a major risk for other liver diseases. Severe corticosteroid-resistant alcoholic acute hepatitis is a debated indication for transplant. However, available data indicate that well-selected patients have excellent post-transplant outcomes. Behavioral therapy, continued psychological support and a multidisciplinary team are essential to achieve and maintain complete alcohol abstinence during the transplant process. Alcoholic liver disease is an excellent indication for a liver transplant but patients with alcohol use disorder deserve a personalized approach and dedicated resources. |
| Databáze: | Directory of Open Access Journals |
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