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KMID : 0870420130170010014
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Korean Journal of Hepato-Biliary-Pancreatic Surgery
2013 Volume.17 No. 1 p.14 ~ p.20
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Living donor liver transplantation for patients with alcoholic liver disease
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Park Yo-Han
Hwang Shin
Ahn Chul-Soo
Kim Ki-Hun
Moon Deok-Bog
Ha Tae-Yong
Song Gi-Won
Jung Dong-Hwan
Park Gil-Chun
Namgoong Jung-Man
Park Hyung-Woo
Park Chun-Soo
Kang Sung-Hwa
Jung Bo-Hyeon
Lee Sung-Gyu
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Abstract
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Backgrounds/Aims: Since most transplantation studies for alcoholic liver disease (ALD) were performed on deceased donor liver transplantation, little was known following living donor liver transplantation (LDLT).
Methods: The clinical outcome of 18 ALD patients who underwent LDLT from Febraury 1997 to December 2004 in a large-volume liver transplantation center was assessed retrospectively.
Results: The model for end-stage liver disease score was 23±11, and mean pretransplant abstinence period was 16±13 months, with 14 (77.8%) patients being abstinent for at least 6 months. Graft types were right lobe grafts in 11, left lobe grafts in 2 and dual grafts in 5. Graft to recipient body weight ratio was 0.94±0.16. The relapse rates in patients who did and did not maintain 6 months of abstinence were 7.1% and 50%, respectively (p=0.097). Younger recipient age was a significant risk factor for alcohol relapse (p=0.027). Five recipients with antibody to hepatitis B surface antigen (HBsAg) received core antibody-positive liver graft, but two of them showed positive HBsAg seroconversion. Overall 5-year patient survival rate following LDLT was 87.8%, with a 5-year relapse rate of 16.7%.
Conclusions: Pretransplant abstinence for 6 months appears to be benefical for preventing posttransplant relapse. Life-long prophylactic measure should be followed after use of anti-HBc-positive liver grafts regardless of hepatitis B viral marker status of the recipient.
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KEYWORD
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Living donor liver transplantation, Alcoholic liver disease, Relapse
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