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Liver transplantation for alcoholic liver disease

Scott L Friedman, MD
Section Editor
Robert S Brown, Jr, MD, MPH
Deputy Editor
Kristen M Robson, MD, MBA, FACG


Historically, physicians were reluct to offer liver transplantation to patients with alcoholic liver disease. However, in appropriately selected patients, it is clear that transplantation offers an excellent survival advantage similar to that for other disease indications. Prior reluctance stemmed from the perception that the disease was self-inflicted and from concern regarding the risk of alcohol-related damage to sites outside the liver [1,2]. There was also concern that relapse and medication noncompliance would lead to graft failure.

Alcoholic cirrhosis was responsible for 21 percent of all orthotopic liver transplants in 2015 in the United States, according to the Organ Procurement and Transplantation Network/Scientific Registry of Transplant Recipients (OPTN/SRTR) report [3]. Liver transplantation appears to be cost-effective for alcoholic liver disease, albeit possibly less so than for transplantation for some indications such as primary biliary cholangitis and primary sclerosing cholangitis [1,4,5].

This topic will review liver transplantation for alcoholic liver disease. The diagnosis and treatment of alcohol use disorder and the pathogenesis, diagnosis, and treatment of alcoholic liver disease are discussed separately.

(See "Risky drinking and alcohol use disorder: Epidemiology, pathogenesis, clinical manifestations, course, assessment, and diagnosis".)

(See "Pathogenesis of alcoholic liver disease".)

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Literature review current through: Nov 2017. | This topic last updated: Nov 14, 2017.
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