Prompt liver transplant boosts survival in heavy drinkers
Some patients with organ inflammation from alcohol can benefit
By Nathan Seppa
Heavy drinkers who have severe liver inflammation are much more likely to survive if they get a prompt liver transplant than if they wait a few months, new research finds. Allowing some alcoholics with a potentially lethal form of liver disease to move up the waiting list for a transplant — a controversial area of transplant policy — would save lives, researchers suggest in the Nov. 10 New England Journal of Medicine.
About 10 to 15 percent of donor livers go to people whose liver disease stems directly from alcohol, says Robert Brown, a hepatologist at Columbia University in New York City who wasn’t involved in the new study. But the number is an estimate at best since many people who qualify for a transplant because of liver damage from other causes might also drink, he says.
In the United States, transplant guidelines require that alcoholics stay sober for six months before they can be placed on the waiting list for a liver transplant. Six months of abstinence and medication improve the health of many people with alcohol-related liver disease, but the delay can be fatal for those with a form of alcohol-induced liver inflammation that doesn’t respond to routine medication. About 70 to 80 percent of people with this condition, called severe alcoholic hepatitis, die within six months.
For the new study, physician Philippe Mathurin of the Claude Huriez Hospital in Lille, France, and his colleagues chose 26 patients to get a liver transplant within a few weeks of being diagnosed with alcoholic hepatitis. The patients had failed to respond to medication such as steroids, the typical treatment for the condition. The researchers also monitored 26 similar patients who didn’t receive transplants.