Liver transplantation for alcoholic hepatitis

Gene Y. Im, Andrew M. Cameron, Michael R. Lucey

Research output: Contribution to journalReview articlepeer-review

Abstract

While liver transplantation (LT) has become a standard therapy for life-threatening alcohol related cirrhosis, LT as a treatment for severe alcoholic hepatitis (AH) has remained a taboo owing to concerns about the limited organ supply and the risk that the AH liver recipient will return to harmful drinking. The adoption of a 6-month abstinence requirement (the so-called ‘6-month rule’) by many centres made AH a contraindication to LT. Given the high short-term mortality of severe AH, the lack of effective medical therapies and an increasing recognition that the 6-month rule unfairly excluded otherwise favourable candidates, a seminal European pilot study of LT for AH was performed. The success of the European study, which has been corroborated in retrospective analyses from the United States, represented a paradigm shift in therapy for highly selected patients with severe AH who are not responding to medical therapy. However, prospective studies are urgently needed to resolve the controversies that still surround the criteria for selection of patients with AH for LT and the long-term outcomes of the associated alcohol use disorder.

Original languageEnglish (US)
Pages (from-to)328-334
Number of pages7
JournalJournal of Hepatology
Volume70
Issue number2
DOIs
StatePublished - Feb 2019

Keywords

  • 6-month rule
  • Alcohol use disorder
  • Alcohol-associated liver disease
  • Alcoholic hepatitis
  • Liver transplantation
  • Relapse

ASJC Scopus subject areas

  • Hepatology

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