Post-transplant Outcomes of Persons Receiving a Liver Graft for Alcoholic Liver Disease.

AIMS: Liver transplantation (LT) for alcoholic liver disease (ALD) remains controversial yet following transplantation outcomes for patients with this disease are generally similar to patients transplanted for other types of liver diseases.

METHODS

In this review, we cover critical literature of ALD LT including established and recent findings of medical and psychosocial outcomes for ALD patients and compare their outcomes to other liver transplant recipients where evidence exists.

RESULTS

Overall medical and psychosocial outcomes for ALD LT recipients compare favorably to patients transplanted for other types of liver diseases. While alcohol relapse occurs following transplant, the rates of return to heavy alcohol use, especially at amounts that are health harmful, are low at ~20%-substantially under rates of relapse for non-transplant patients with alcohol use disorders. However, ALD LT recipients are more likely to be smokers and experience causes of death different than other LT recipients with cardiovascular and malignancies being more common. Depression is one of the more common mental health disorders experienced by ALD LT recipients and is especially important to consider due to increasing evidence of its negative impact on post-transplant survival. In general, ALD LT recipients' quality of life is as good as recipients transplanted for other types of liver disease. Post-LT re-employment and social reintegration are also comparable.

CONCLUSIONS

Early identification may improve outcomes with the first post-transplant year being an important time for close monitoring. Additionally, efforts to identify and treat tobacco use and depression may also improve overall outcomes in this specific population.

SHORT SUMMARY: In this review, we cover medical and psychosocial outcomes for ALD patients and compare their outcomes to other liver transplant recipients. While alcohol relapse occurs following transplant, the rates of return to heavy alcohol use, especially at amounts that are health harmful, are low at ~20%.