Liver Transplantation for Severe Alcoholic Hepatitis Crosses the Atlantic

Abstract

In 2011, Mathurin and colleagues demonstrated, in a ground-breaking pilot study from France and Belgium, that rescue liver transplantation could save the lives of carefully selected patients with severe alcoholic hepatitis who had failed medical treatment (1). Their report challenged the view that patients with severe alcoholic hepatitis were unsuitable candidates for liver transplantation, which has prevailed for many years (2).

Outcomes of Liver Transplantation for Severe Alcohol‐Related Hepatitis

“…There were several alcohol‐related deaths after LT, suggesting the need for further study of pre‐LT selection of candidates at low risk for relapse and post‐LT alcohol addiction support. These results further demonstrated the medical and surgical feasibility of early LT for AH and provided an early roadmap for other LT centers considering this indication as a rescue therapy for severe AH …”

Biochemical Studies in Perfundates and Homogenates of Isolated Porcine Kidneys after Flushing with Zinc or Zinc–Prolactin Modified Preservation Solution Using a Static Cold Storage Technique

“…However, Biolasol provided more optimal homeostasis, which may suggest its better nephroprotective properties. Jóźwik et al [ 17 ] transplanted 42 human kidneys, which were previously stored by simple hypothermia in Biolasol and the reference solution—UW. They found that delayed graft function occurred in both groups of patients (38% of cases in the Biolasol group vs. 33% in the UW group, p = ns).…”

Early liver transplantation for severe alcoholic hepatitis

“…Although the European trial generated significant interest (and controversy), the results were not reproduced until 2016, with a case–control study from Mount Sinai demonstrating similarly excellent survival (89% versus 11%), low relapse (12.5%), and low burden on donor pool (3%) . Examination of methodology adaptation and insights into candidate selection were considered a vade mecum for other LT centers in the United States . Since starting our program of early LT for severe AH in 1/2012, we have evaluated >200 severe AH nonresponders and waitlisted 20% with favorable psychosocial profiles.…”

“…20 Examination of methodology adaptation and insights into candidate selection were considered a vade mecum for other LT centers in the United States. 21 Since starting our program of early LT for severe AH in 1/2012, we have evaluated >200 severe AH nonresponders and waitlisted 20% with favorable psychosocial profiles. We have now performed 28 early LT, with 92% overall survival and 15% relapse rate at a median 2 years of followup.…”