J Korean Med Sci.  2017 Jun;32(6):919-925. 10.3346/jkms.2017.32.6.919.

Korean Patients Undergoing Deceased Donor Liver Transplantation for Alcoholic Liver Disease Have Non-Inferior Survival Outcomes than for Hepatitis B Virus: a Real-World Experience without Minimum Abstinence before Transplantation

• Hong SK
• Yi NJ
• Kim HS
• Ahn SW
• Yoon KC
• Kim H
• Lee KW
• Suh KS

• KMID: 2377720
• DOI: http://doi.org/10.3346/jkms.2017.32.6.919

Abstract

Few studies have compared outcomes in patients undergoing liver transplantation (LT) for hepatitis B virus (HBV) and alcoholic liver disease (ALD) in Asian countries in which living donor LT (LDLT) is dominant, where HBV is endemic and where there are no strict regulations on pre-transplant abstinence for ALD. This study compared post-LT outcomes of deceased donor LT (DDLT) in patients with ALD and HBV. Data from 220 patients who underwent primary DDLT at Seoul National University Hospital from January 2010 to December 2014, including 107 with HBV and 38 with ALD, were retrospectively analyzed. Seventy-four patients (69.2%) in the HBV group and 30 (78.9%) in the ALD group had United Network for Organ Sharing (UNOS) status 2A (P = 0.250). There were no significant differences in their 1-year (90.7% vs. 92.1%) and 3-year (82.1% vs. 82.3%) overall survival rates (P = 1.000). Multivariate analysis showed that high serum gamma glutamyltransferase concentration (≥ 70 IU/L) was independently prognostic of 1-year post-LT overall survival. Survival outcomes following DDLT were similar in Korean patients with ALD and HBV, even in the absence of strict pre-transplant abstinence from alcohol as a selection criterion.

Keyword

Alcohol; Liver Cirrhosis; Liver Transplantation; Outcome

MeSH Terms

Alcoholics*
Asian Continental Ancestry Group
gamma-Glutamyltransferase
Hepatitis B virus*
Hepatitis B*
Hepatitis*
Humans
Liver Cirrhosis
Liver Diseases, Alcoholic*
Liver Transplantation*
Liver*
Living Donors
Multivariate Analysis
Retrospective Studies
Seoul
Social Control, Formal
Survival Rate
Tissue Donors*
gamma-Glutamyltransferase

Figure

• 

  Fig. 1 Kaplan-Meier analysis of overall survival in (A) all patients and (B) patients without HCC. HCC = hepatocellular carcinoma, LT = liver transplantation, HBV = hepatitis B virus.

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