Liver transplantation for severe alcoholic hepatitis-The CON view.
Liver Int
; 37(3): 340-342, 2017 03.
Article
em En
| MEDLINE
| ID: mdl-28240836
ABSTRACT
In patients with severe alcoholic hepatitis (AH) who have failed medical therapy, liver transplantation (LT) remains a controversial therapeutic option. This is exemplified by the fact that most of these patients will not have had a period of abstinence prior to consideration for transplantation. Both abstinence before transplantation and the duration of abstinence are important predictors of post-transplant relapse. Furthermore, relapse after transplantation has been associated with accelerated graft injury and increase mortality. Recent pilot studies have demonstrated a benefit in short-term survival with early transplantation in highly selected small number of patients compared to matched controls. The results of these studies raises the possibility of extending graft allocation to these subjects. Despite stringent assessment and a multi-tiered approach to selecting out patients for transplantation, the relapse rate was not insignificant at 12%. As the long-term outcome remains unclear, further relapses with time can still occur. These studies also highlight the fact that the overwhelming majority of subjects with severe AH who are non-responsive to medical therapy are not suitable for LT. Indeed, further large-scale multicentre prospective studies with long-term follow-up are required to confirm the preliminary findings.
Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Contexto em Saúde:
2_ODS3
/
4_TD
/
6_ODS3_enfermedades_notrasmisibles
Problema de saúde:
2_enfermedades_transmissibles
/
4_hepatitis
/
6_digestive_diseases
Assunto principal:
Transplante de Fígado
/
Falência Hepática
/
Seleção de Pacientes
/
Hepatite Alcoólica
Tipo de estudo:
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Humans
Idioma:
En
Revista:
Liver Int
Assunto da revista:
GASTROENTEROLOGIA
Ano de publicação:
2017
Tipo de documento:
Article
País de afiliação:
China