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Lower relapse rates with good post-transplant outcome in alcoholic liver disease: Experience from a living donor liver transplant center

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Indian Journal of Gastroenterology Aims and scope Submit manuscript

Abstract

Introduction

Post-transplant relapse is a major factor influencing the long-term outcome in alcoholic liver disease (ALD) patients.

Aims

The aim of this study was to evaluate the relapse rates following living donor liver transplantation (LDLT) in patients with ALD in the Indian context with strong family support.

Methods

Of 458 patients who underwent LDLT for ALD, 408 were included in the study. Post-transplant relapse was determined by information provided by the patient and/or family by means of outpatient and e-mail questionnaire, supported by clinical/biochemical parameters/liver histopathology.

Results

All except one were males, with a mean age of 46.9 ± 8.5 years. The overall rate of relapse was 9.5 % at 34.7 months (interquartile range (IQR) 15–57.6), lower than that reported in the literature from the West. The relapse rate was higher in patients with a shorter duration of pre-transplant abstinence (17.4 % and 15.4 % for recipients with pre-transplant abstinence of <3 and <6 months, respectively, p < 0.05). The overall survival was 88.5 % at 3 years. Of 39 patients with relapse, 16 (41 %) were occasional drinkers, 14 (35.8 %) were moderate drinkers, and 9 (23 %) were heavy drinkers. All the heavy drinkers presented with features of graft dysfunction.

Conclusions

Good results can be obtained following LDLT for ALD, with significantly lower relapse rates in our setup as compared to the West.

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Acknowledgments

The authors thank Mr. Yogesh Saini (clinical research coordinator) and Mr. Manish (bio-statistician) for their help in this study.

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Authors and Affiliations

  1. Medanta Institute of Liver Transplantation and Regenerative Medicine, Gurgaon, Delhi (NCR), 122 002, India

    Sanjiv Saigal, Narendra Singh Choudhary, Sanjay Kumar Yadav, Neeraj Saraf, Naveen Kumar, Rahul Rai, Amit Rastogi, Sanjay Goja, Prashant Bhangui, Sumana K. Ramachandra, Vikram Raut & Arvinder Singh Soin

  2. Department of Mental Health and Quality of Life, Medanta - The Medicity, Gurgaon, Delhi (NCR), 122 002, India

    Saurabh Mehrotra & Vipul Rastogi

  3. Department of Histopathology, Medanta - The Medicity, Gurgaon, Delhi (NCR), 122 002, India

    Dheeraj Gautam

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  1. Sanjiv Saigal
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Corresponding author

Correspondence to Sanjiv Saigal.

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Conflict of interest

SS, NSC, SKY, NS, NK, RR, SM, VR, AR, SG, PB, SKR, VR, DG, and ASS declare that they have no conflict of interest.

Ethics statement

The authors declare that the study was performed in a manner to conform with the Helsinki Declaration of 1975, as revised in 2000 and 2008, concerning human and animal rights, and the authors followed the policy concerning informed consent as shown on Springer.com.

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Saigal, S., Choudhary, N.S., Yadav, S.K. et al. Lower relapse rates with good post-transplant outcome in alcoholic liver disease: Experience from a living donor liver transplant center. Indian J Gastroenterol 35, 123–128 (2016). https://doi.org/10.1007/s12664-016-0646-z

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  • DOI: https://doi.org/10.1007/s12664-016-0646-z

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