End-stage liver disease secondary to alcoholic cirrhosis conThe prediction of abstinence from ethanol may be tinues to be a significant cause of death. 1 Most alcoholics with crucial to the optimal selection of liver transplantation end-stage liver disease do not have significant extrahepatic candidates with alcoholism. Of 84 consecutive end-stage complications of ethanol abuse. 2 Therefore, these patients are alcoholic patients who underwent transplantation not usually excluded because of other terminal medical condi-(1986-1994) at our institution, we analyzed 63 long-surtions, and many times will die shortly without transplantaviving recipients for pretransplantation variables to tion intervention. 2 Furthermore, excellent survival following predict posttransplantation abstinence (follow-up: 49.3 liver transplantation is noted with alcoholic recipients. [3][4][5][6][7][8][9][10][11] Be-{ 21 mo). Thirty-three pretransplantation variables cause these patients usually have liver disease solely because were reviewed from our transplantation data base and of the intake of a toxin (ie, ethanol), abstinence from this supplemented and confirmed with interviews with retoxin usually predicts minimal problems with liver disease cipients. The psycho-social inclusion criteria included following liver transplantation. The appropriate allocation of the following: patient recognition of alcoholism, a domiliver transplantation to specific alcoholic patients is made cile, an occupation, and at least one close personal relamore difficult by the large number of patients with end-stage tionship. The incidence of abstinence from ethanol was alcoholic cirrhosis and the intense demand for donor organs (50/63) 79%. A logistic regression of the 33 variables in for other end-stage liver diseases in which disease recurrence conjunction with our above inclusion criteria accurately may be less likely or more predictable. 12-14 Herein lies the predicted abstinence (90% accuracy, x 2 model, P õ problem that besets transplantation physicians: the appro-.00001) based on the absence of previous history of any priate selection of alcoholics with end-stage liver disease for illicit drug use (Drug Use: yes Å 1/no Å 0), the presence transplantation based on the prediction of long-term abstiof an active, personal life insurance policy (Life Ins: yes nence from alcohol. number of alcoholic sisters (ETOH-SIS), andThe aims of this study are to describe the following: 1) the the length of pretransplantation abstinence (PREresults of liver transplantation for patients with alcoholic TRANS-ABS, mos): Prob. of abstinence Å 1/1 / e 0F , F Å end-stage liver disease (survival, the incidence of abstinence, 00.33 / 0.89 (DRUG USE) 01.02 (LIFE INS) 01.68 (ETOHand pattern of recidivism); and 2) an analysis of pretrans-SIS) /0.24 (PRE-TRANS-ABS). In contrast, receiver-opplantation variables that may predict abstinence from alcohol erating characteristic curve analysis found that 7 and 9 following transplantation. months of pretransplantation abstinence were the be...
Seventh Day Syndrome is a distinct entity associated with early graft dysfunction characterized by a marked apoptosis of hepatocytes. Fas receptor activation or other pathways of program cell death may be implicated in occurrence of 7DS.
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