Article Dans Une Revue (Article De Synthèse) Journal of Clinical and Experimental Hepatology Année : 2023

Liver Transplantation in Alcohol-related Liver Disease and Alcohol-related Hepatitis.

Résumé

Alcohol-related liver disease (ARLD) remains one of the leading causes of chronic liver disease and the prevalence of alcohol-related cirrhosis is still increasing worldwide. Thus, ARLD is one of the leading indications for liver transplantation (LT) worldwide especially after the arrival of direct-acting antivirals for chronic hepatitis C infection. Despite the risk of alcohol relapse, the outcomes of LT for ARLD are as good as for other indications such as hepatocellular carcinoma (HCC), with 1-, 5-, and 10- year survival rates of 85%, 74%, and 59%, respectively. Despite these good results, certain questions concerning LT for ARLD remain unanswered, in particular because of persistent organ shortages. As a result, too many transplantation centers continue to require 6 months of abstinence from alcohol for patients with ARLD before LT to reduce the risk of alcohol relapse even though compelling data show the poor prognostic value of this criterion. A recent pilot study even observed a lower alcohol relapse rate in patients receiving LT after less than 6 months of abstinence as long as addictological follow-up is reinforced. Thus, the question should not be whether LT should be offered to patients with ARLD but how to select patients who will benefit from this treatment.
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hal-04489847 , version 1 (08-01-2025)

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Line-Carolle Ntandja Wandji, Massih Ningarhari, Guillaume Lassailly, Sebastien Dharancy, Emmanuel Boleslawski, et al.. Liver Transplantation in Alcohol-related Liver Disease and Alcohol-related Hepatitis.. Journal of Clinical and Experimental Hepatology, 2023, Journal of Clinical and Experimental Hepatology, 13, pp.127-138. ⟨10.1016/j.jceh.2022.06.013⟩. ⟨hal-04489847⟩
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