Lower relapse rates with good post-transplant outcome in alcoholic liver disease: Experience from a living donor liver transplant center

Indian J Gastroenterol. 2016 Mar;35(2):123-8. doi: 10.1007/s12664-016-0646-z. Epub 2016 Apr 29.

Abstract

Introduction: Post-transplant relapse is a major factor influencing the long-term outcome in alcoholic liver disease (ALD) patients.

Aims: The aim of this study was to evaluate the relapse rates following living donor liver transplantation (LDLT) in patients with ALD in the Indian context with strong family support.

Methods: Of 458 patients who underwent LDLT for ALD, 408 were included in the study. Post-transplant relapse was determined by information provided by the patient and/or family by means of outpatient and e-mail questionnaire, supported by clinical/biochemical parameters/liver histopathology.

Results: All except one were males, with a mean age of 46.9 ± 8.5 years. The overall rate of relapse was 9.5 % at 34.7 months (interquartile range (IQR) 15-57.6), lower than that reported in the literature from the West. The relapse rate was higher in patients with a shorter duration of pre-transplant abstinence (17.4 % and 15.4 % for recipients with pre-transplant abstinence of <3 and <6 months, respectively, p < 0.05). The overall survival was 88.5 % at 3 years. Of 39 patients with relapse, 16 (41 %) were occasional drinkers, 14 (35.8 %) were moderate drinkers, and 9 (23 %) were heavy drinkers. All the heavy drinkers presented with features of graft dysfunction.

Conclusions: Good results can be obtained following LDLT for ALD, with significantly lower relapse rates in our setup as compared to the West.

Keywords: Alcoholic liver disease; Liver transplant; Living donor liver transplantation.

MeSH terms

  • Adult
  • Female
  • Health Facilities / statistics & numerical data*
  • Humans
  • India / epidemiology
  • Liver Diseases, Alcoholic / epidemiology*
  • Liver Diseases, Alcoholic / mortality
  • Liver Diseases, Alcoholic / surgery*
  • Liver Transplantation / mortality
  • Liver Transplantation / statistics & numerical data*
  • Living Donors*
  • Male
  • Middle Aged
  • Recurrence
  • Surveys and Questionnaires
  • Survival Rate
  • Time Factors
  • Treatment Outcome