Comparison of 1-year morbidity following liver transplant for acute alcoholic hepatitis versus alcoholic cirrhosis

Oya M. Andacoglu, Umut Özbek, Jack Liu, Carlos Figueredo, Kristina R. Chacko, Clara Tow, John F. Reinus, Milan Kinkhabwala

Research output: Contribution to journalArticlepeer-review

Abstract

Objectives: With limited data on the morbidity profile of liver transplant as therapy for alcoholic hepatitis, we compared 30-day and 1-year morbidity in liver transplant recipients with alcoholic hepatitis versus alcoholic cirrhosis. Materials and Methods: We retrospectively reviewed 38 perioperative variables in patients with alcoholic hepatitis (n = 15) and with alcoholic cirrhosis (n = 46). Multivariable analysis was performed to identify factors independently associated with outcomes. Results: Patients with alcoholic hepatitis were younger (43 vs 58 years; P =.001), with higher pretransplant Model for End-Stage Liver Disease scores (36 vs 29; P =.009) and worse Karnofsky scores (20 vs 50; P <.001). All patients with alcoholic hepatitis received standard criteria deceased donor grafts; however, in the alcoholic cirrhosis group, 64% received standard criteria deceased, 11% living, 11% after cardiac death, 9% extended criteria, and 2% split graft donor organ donations (P >.05). The alcoholic hepatitis group had higher degree of steatosis on explant (P <.005), and the alcoholic cirrhosis group had higher 30-day reoperation rate (P =.001); however, 1-year interventions, vascular and biliary complications, graft and patient survival, and all other variables were similar (P >.05). Rates of alcohol relapse, 1-year infection, and 1-year rejection were higher but not significant (P >.05) in the alcoholic hepatitis group. Thirty-day reoperation (odds ratio of 82.63; 95% CI, 8.02-3338.96; P =.002) and Karnofsky scores (odds ratio of 1.18; 95% CI, 1.08-1.36; P =.006) remained significant on multivariate analysis. Conclusions: Our results showed significant differences between our patient groups, including worse functional status in the alcoholic hepatitis group but significantly higher 30-day reoperation rates and more variable grafts in the alcoholic cirrhosis group, although both groups had similar overall 1-year complication and survival rates. Although not significant, patients with alcoholic hepatitis had higher alcohol relapse and 1-year infection and rejection rates. A larger cohort is necessary to confirm the strength of these findings.

Original languageEnglish (US)
Pages (from-to)439-444
Number of pages6
JournalExperimental and Clinical Transplantation
Volume19
Issue number5
DOIs
StatePublished - May 2021

Keywords

  • Alcoholic liver disease
  • Functional status
  • Surgical morbidity

ASJC Scopus subject areas

  • Transplantation

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