Digestive Disease Week
Digestive Disease Week
Perspective from Paul Y. Kwo, MD
June 04, 2018
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Relapse after LT for alcoholic liver disease more common in younger patients

Perspective from Paul Y. Kwo, MD
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WASHINGTON — Relapse to alcohol use after liver transplantation for alcoholic liver disease was more common among younger patients, according to a study presented at Digestive Disease Week 2018.

“Alcoholic liver disease is the second most common indication for liver transplant,” Mohanad Turki Ali Al-Qaisi, MD, from the Mayo Clinic in Phoenix, Ariz., said in his presentation. “Timing of alcohol relapse after LT can have a detrimental impact on patient survival.”

Al-Qaisi conducted a retrospective chart review of patients who underwent LT for alcoholic liver disease between 1999 and 2015 with at least 1 year of follow-up to establish the rate of alcohol relapse posttransplant and define predictive factors.

The researchers defined early relapse as any resumption of alcohol use within 1 year posttransplant and late relapse as any resumption of alcohol use after 1 year.

Of the 928 patients included in the study, 203 underwent LT for the first time due to alcoholic liver disease, and 28 patients relapsed within a median follow-up of 6.5 years.

Patients who relapsed were significantly more likely to be younger than those who did not relapse (49.8 vs. 54.1 years; P = .011). Multivariate analysis confirmed the significance of age related to relapse (HR = 1.083; 95% CI, 1.027-1.142).

Patients transplanted under a standardized exception pathway — without 6 months prior sobriety — were also more likely to relapse compared with those who followed normal pathway (40% vs. 12.4%).

Patients who relapsed within 1 year had lower survival compared with those who relapsed after 1 year and those who did not relapse at all, but the difference was not significant.

“We propose patients at risk of relapse should be targeted with intervention shortly after transplant to help improve their outcome,” Al-Qaisi concluded. – by Talitha Bennett

Reference :

Al-Qaisi MTA, et al. Abstract 503. Presented at: Digestive Disease Week; June 2-5, 2018; Washington, D.C.

Disclosure: Al-Qaisi reports no relevant financial disclosures. Please see the DDW faculty disclosure index for a list of all other authors’ relevant financial disclosures.