Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Multicenter Study
. 2022 Apr;22(4):1191-1200.
doi: 10.1111/ajt.16936. Epub 2022 Jan 8.

Liver transplantation for severe alcoholic hepatitis: A multicenter Italian study

Giacomo Germani  1 , Debora Angrisani  2 , Giovanni Addolorato  3   4 , Manuela Merli  5 , Chiara Mazzarelli  2 , Claudia Tarli  3 , Barbara Lattanzi  5 , Adelaide Panariello  6 , Paola Prandoni  6 , Lucia Craxì  7 , Giovanni Forza  8 , Alessandra Feltrin  9 , Andrea Ronzan  10 , Paolo Feltracco  11 , Antonio Grieco  12 , Salvatore Agnes  13 , Antonio Gasbarrini  4 , Massimo Rossi  14 , Luciano De Carlis  15   16 , D'Amico Francesco  17 , Umberto Cillo  17 , Luca S Belli  2 , Patrizia Burra  1
Affiliations
Free article
Multicenter Study

Liver transplantation for severe alcoholic hepatitis: A multicenter Italian study

Giacomo Germani et al. Am J Transplant. 2022 Apr.
Free article

Abstract

There is increasing evidence that early liver transplantation (eLT), performed within standardized protocols can improve survival in severe alcoholic hepatitis (sAH). The aim of the study was to assess outcomes after eLT for sAH in four Italian LT centers and to compare them with non-responders to medical therapy excluded from eLT. Patients admitted for sAH (2013-2019), according to NIAAA criteria, were included. Patients not responding to medical therapy were placed on the waiting list for eLT after a strict selection. Histological features of explanted livers were evaluated. Posttransplant survival and alcohol relapse were evaluated. Ninety-three patients with severe AH were evaluated (65.6% male, median [IQR] age: 47 [42-56] years). Forty-five of 93 patients received corticosteroids, 52 of 93 were non-responders and among these, 20 patients were waitlisted. Sixteen patients underwent LT. Overall, 6-, 12-, and 24-month survival rates were 100% significantly higher compared with non-responders to medical therapy who were denied LT (45%, 45%, and 36%; p < .001). 2/16 patients resumed alcohol intake, one at 164 days and one at 184 days. Early LT significantly improves survival in sAH non-responding to medical therapy, when a strict selection process is applied. Further studies are needed to properly assess alcohol relapse rates.

Keywords: alcoholism and substance abuse; clinical decision-making; clinical research/practice; liver transplantation/hepatology.

PubMed Disclaimer

References

REFERENCES

    1. Lucey MR, Mathurin P, Morgan TR. Alcoholic hepatitis. N Engl J Med. 2009;360(26):2758-2769. doi:10.1056/NEJMra0805786
    1. Liangpunsakul S. Clinical characteristics and mortality of hospitalized alcoholic hepatitis patients in the United States. J Clin Gastroenterol. 2011;45(8):714-719. doi:10.1097/MCG.0b013e3181fdef1d
    1. Sandahl TD, Jepsen P, Thomsen KL, Vilstrup H. Incidence and mortality of alcoholic hepatitis in Denmark 1999-2008: a nationwide population based cohort study. J Hepatol. 2011;54(4):760-764. doi:10.1016/j.jhep.2010.07.016
    1. Louvet A, Naveau S, Abdelnour M, et al. The Lille model: a new tool for therapeutic strategy in patients with severe alcoholic hepatitis treated with steroids. Hepatology. 2007;45(6):1348-1354. doi:10.1002/hep.21607
    1. Bathgate AJ, Units ULT. Recommendations for alcohol-related liver disease. Lancet. 2006;367(9528):2045-2046. doi:10.1016/S0140-6736(06)68904-6

Publication types