Outcomes and predictors of harmful relapse following liver transplantation for alcoholic liver disease in an Australian population.
Intern Med J
; 47(6): 656-663, 2017 Jun.
Article
em En
| MEDLINE
| ID: mdl-28321963
ABSTRACT
BACKGROUND:
Limited studies of patient survival and alcoholic relapse following transplantation for alcoholic liver disease have been described in Australian populations.AIM:
To describe these outcomes in an Australian population, to determine the association between harmful alcoholic relapse and patient survival, and to examine pre-transplant variables associated with harmful relapse.METHODS:
Single centre, retrospective review of consecutive patients transplanted at the South Australian Liver Transplant Unit. Relapse was identified by an independent investigator using case note review and confidential patient questionnaire.RESULTS:
A total of 87 patients (median age 52 years, 84% male, median Model for End-Stage Liver Disease (MELD) score 18) was included in the study with a median follow-up time of 50 months. The 1-, 3- and 5-year survival of patients was 93.1, 87.4 and 82.0% respectively. Two deaths were directly attributable to graft failure due to alcohol. Fourteen (16%) patients fulfilled criteria for harmful relapse and 18 (21%) patients experienced any form of relapse to alcohol. Harmful relapse was associated with increased mortality (hazard ratio (HR) 3.2, 95% confidence interval (CI) 1.1-9.7, P = 0.041). Only two factors were independently associated with harmful relapse on multivariate analysis; prior alcohol rehabilitation (HR 8.4, 95% CI 2.5-28.4, P = 0.001) and single versus married status (HR 0.09, 95% CI 0.02-1.2, P = 0.019).CONCLUSION:
Good patient survival outcomes were seen for this South Australian population. Harmful alcohol relapse occurs in a minority of patients and rarely results in direct graft loss. Modifiable pre-transplant factors that predict harmful relapse were not identified.Palavras-chave
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Base de dados:
MEDLINE
Assunto principal:
Vigilância da População
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Transplante de Fígado
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Alcoolismo
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Hepatopatias Alcoólicas
Idioma:
En
Ano de publicação:
2017
Tipo de documento:
Article