Orthotopic liver transplantation for alcoholic cirrhosis

Abstract

Fifteen patients with Laennec's cirrhosis underwent orthotopic liver transplantation between 1963 and the end of 1979. The first eight patients died perioperatively or within two months, but four of the next seven patients had long survival; three are still alive after 11 to 14 years. After the introduction of cyclosporine therapy, 41 more patients with alcoholic cirrhosis were treated with liver transplantation from 1980 to June 1987. The one-year survival is 73.2%, and, after one to three years, 28 (68%) of the recipients are living. Of the 35 patients in the combined old and new series who lived for six months or longer, only two returned to alcohol abuse. Social and vocational rehabilitation has been the rule in these recipients who were selected primarily because of urgency of need, because they or their families insisted on treatment, and because they and their families thereby committed themselves to long-standing programs of alcoholism care.

Fig 1

Survival (Kaplan-Meier method) atter liver transplantation for alcoholic cirrhosis for 15 palients treated in precyclosporine era (open circles) and 41 patients treated with cyclosporine (solid circles). Differences in survival during these two trealment periods are significant (P<.001).

Fig 2

Survival (Kaplan-Meier method) after liver transplantation for alcoholic cirrhosis of 41 patients treated wrth cyclosporine (solid line) is compared with survival of 625 adult patients who received transplants for other causes of liver failure (dashed line). All patients were treated with cyclosporine. There is no significant difference in survival between the two groups of patientS (P>.77).