Journal
JOURNAL OF HEPATOLOGY
Volume 78, Issue 6, Pages 1130-1136Publisher
ELSEVIER
DOI: 10.1016/j.jhep.2023.03.007
Keywords
Liver transplantation; alcohol-related hepatitis; alcohol-related liver disease; patient survival; return to alcohol use; LDLT
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In patients with severe acute alcohol-related hepatitis, liver transplantation is the only effective therapy, but there is still limited access to transplantation due to emphasis on pre-transplant abstinence and societal stigma. Therefore, there is a growing need for multicenter studies to improve selection practices and interventions for alcohol use disorder after transplantation.
In patients with severe acute alcohol-related hepatitis not responding to medical therapy, early liver transplantation (LT) represents the only effective therapy and, when performed within strict and well-defined protocols, it is associated with a clear survival benefit and acceptable rates of return to alcohol use after transplantation. However, there is still high variability in access to LT for patients with severe alcohol-related hepatitis, mainly due to a persistent overemphasis in the pre-LT evaluation on duration of pre -transplant abstinence and the stigma that patients with alcohol-related liver disease often experience, leading to marked ineq-uity of access to this potentially lifesaving procedure and negative health outcomes. Therefore, there is an increasing need for prospective multicentre studies focusing on pre-transplant selection practices and on better interventions to treat alcohol use disorder after LT. (c) 2023 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.
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