Liver transplantation is justified for alcoholic cirrhosis, researchers from Saint Eloi Hospital in Montpellier, France, have reported in Gut (1999;45:421-426).
G-P. Pageaux and colleagues studied 53 patients who received liver transplants for alcoholic cirrhosis and 48 patients who received transplants for nonalcoholic liver disease between 1989 and 1994. One- and five-year survival rates were similar between groups: 75% and 62%, respectively, for the patients with alcoholic cirrhosis and 83% and 61%, respectively, for patients with nonalcoholic liver disease.
Of a number of variables the authors studied, recovery of employment after transplantation was the only significantly different variable between the alcoholic (30%) and nonalcoholic (60%) patients who survived more than three months after transplantation. Six alcoholic patients and seven nonalcoholic patients required retransplantation.
"The major argument against widespread use of liver transplantation for patients with alcoholic cirrhosis has been the fear of a high rate of recidivism leading to loss of the graft," the authors said. In addition, they claimed, "there has been some discrimination against alcoholics in liver transplant programs." However, the 32% overall rate of recidivism the authors observed in their patients did not affect survival and compliance with immunosuppressive therapy.
"The good results obtained for liver transplantation for alcoholic cirrhosis should help us to educate the general population about alcoholic liver disease," they concluded.
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