Abstract
Liver transplantation is a definitive therapy for patients with end-stage liver disease and cirrhosis, with improvement in survival and quality of life. Patients are carefully screened and selected for this modality of treatment to achieve maximum survival benefit. For example, a patient with hepatocellular carcinoma is a candidate if he or she is within Milan criteria and has no significant comorbidity. Similarly, patients with alcoholic cirrhosis are transplant candidates if they are deemed to have been rehabilitated from abusive alcohol consumption and are at low risk for recidivism. More recently, carefully selected patients with alcoholic hepatitis have been successfully transplanted. The preferred transplantation modality is cadaveric liver transplantation. However, living donor liver transplantation is carried out if there is no cadaveric liver organ allocation system, or if the patient is deemed to be at low priority for cadaveric organ transplantation based on the allocation system. Living donor liver transplantation for alcoholic hepatitis needs to be addressed with this background in mind.
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References
Raia S, Nery JR, Mies S. Liver transplantation from live donors. Lancet 1989;2:497
Freise CE, Gillespie BW, Koffron AJ, Lok AS, Pruett TL, Emond JC, Fair JH, et al. Recipient morbidity after living and deceased donor liver transplantation: findings from the A2ALL Retrospective Cohort Study. Am J Transplant 2008;8:2569–2579
Singal AK, Kamath PS, Gores GJ, Shah VH. Alcoholic hepatitis: current challenges and future directions. Clin Gastroenterol Hepatol 2014;12:555–564
Thursz MR, Richardson P, Allison M, Austin A, Bowers M, Day CP, Downs N, et al. Prednisolone or pentoxifylline for alcoholic hepatitis. N Engl J Med 2015;372:1619–1628
Garg V, Garg H, Khan A, Trehanpati N, Kumar A, Sharma BC, Sakhuja P, et al. Granulocyte colony-stimulating factor mobilizes CD34(+) cells and improves survival of patients with acute-on-chronic liver failure. Gastroenterology 2012;142:505–512 (e501)
Singal AK, Duchini A. Liver transplantation in acute alcoholic hepatitis: current status and future development. World J Hepatol 2011;3:215–218
McCallum S, Masterton G. Liver transplantation for alcoholic liver disease: a systematic review of psychosocial selection criteria. Alcohol Alcohol 2006;41:358–363
Mathurin P, Moreno C, Samuel D, Dumortier J, Salleron J, Durand F, Castel H, et al. Early liver transplantation for severe alcoholic hepatitis. N Engl J Med 2011;365:1790–1800
Singal AK, Bashar H, Anand BS, Jampana SC, Singal V, Kuo YF. Outcomes after liver transplantation for alcoholic hepatitis are similar to alcoholic cirrhosis: exploratory analysis from the UNOS database. Hepatology 2012;55:1398–140
Im GY, Kim-Schluger L, Shenoy A, Schubert E, Goel A, Friedman SL, Florman S, et al. Early Liver Transplantation for Severe Alcoholic Hepatitis in the United States-A Single-Center Experience. Am J Transplant 2016;16:841–849
Olthoff KM, Abecassis MM, Emond JC, Kam I, Merion RM, Gillespie BW, Tong L, et al. Outcomes of adult living donor liver transplantation: comparison of the adult-to-adult living donor liver transplantation cohort study and the national experience. Liver Transpl 2011;17:789–797
Selzner M, Kashfi A, Cattral MS, Selzner N, McGilvray ID, Greig PD, Levy GA, et al. Live donor liver transplantation in high MELD score recipients. Ann Surg 2010;251:153–157
Gustot T, Maillart E, Bocci M, Surin R, Trepo E, Degre D, Lucidi V, et al. Invasive aspergillosis in patients with severe alcoholic hepatitis. J Hepatol 2014;60:267–274
Dew MA, DiMartini AF, Steel J, De Vito Dabbs A, Myaskovsky L, Unruh M, Greenhouse J. Meta-analysis of risk for relapse to substance use after transplantation of the liver or other solid organs. Liver Transpl 2008;14:159–172
Abecassis MM, Fisher RA, Olthoff KM, Freise CE, Rodrigo DR, Samstein B, Kam I, et al. Complications of living donor hepatic lobectomy—a comprehensive report. Am J Transplant 2012;12:1208–1217
Hwang S, Lee SG, Lee YJ, Sung KB, Park KM, Kim KH, Ahn CS, et al. Lessons learned from 1,000 living donor liver transplantations in a single center: how to make living donations safe. Liver Transpl 2006;12:920–927
Hashikura Y, Ichida T, Umeshita K, Kawasaki S, Mizokami M, Mochida S, Yanaga K, et al. Donor complications associated with living donor liver transplantation in Japan. Transplantation 2009;88:110–114
Amer KE, Marwan I. Living donor liver transplantation in Egypt. Hepatobiliary Surg Nutr 2016;5:98–106
Narasimhan G. Living donor liver transplantation in India. Hepatobiliary Surg Nutr 2016;5:127–132
Nagral S, Nanavati A, Nagral A. Liver Transplantation in India: At the Crossroads. J Clin Exp Hepatol 2015;5:329–340
Acknowledgements
This work was supported by the Faculty development grant from the American College of Gastroenterology and Grants from the NIH NIAAA, R21AA023273-01A1and U01 AA 21788.
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Ashwani K. Singal and Patrick S. Kamath have no conflict of interest.
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Singal, A.K., Kamath, P.S. Live donor liver transplantation for alcoholic hepatitis. Hepatol Int 11, 34–37 (2017). https://doi.org/10.1007/s12072-016-9770-1
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DOI: https://doi.org/10.1007/s12072-016-9770-1