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Because of the donor shortage, there are concerns for liver transplantation in patients with alcoholic cirrhosis. We therefore analyzed patients transplanted for alcoholic cirrhosis at our center with respect to patient and graft survival, recurrence of disease, and postoperative complications. Out of 1000 liver transplantations performed in 911 patients, 167 patients were transplanted for alcoholic cirrhosis; 91 patients received CsA- and 76 patients FK506-based immunosuppression. Recurrence was diagnosed by patient's or relative's declaration, blood alcohol determination, and delirium. Diagnosis and treatment of acute and chronic rejection was performed as previously described. One- (96.8% versus 91.3%) and 9-year patient survival (83.3% versus 80%) compared well with other indications. Five of 15 patients died due to disease recurrence. Recurrence of disease was significantly related to the duration of alcohol abstinence prior to transplantation. In patients who were abstinent for less than 6 months (17.1%), recurrence rate was 65%, including four of the five patients who died of recurrence. Recurrence rate decreased to 11.8%, when abstinence time was 6-12 months and to 5.5%, when the abstinence times was > 2 years. Next to duration of abstinence, alcohol relapse was significantly related to sex, social environment, and psychological stability. The incidence of acute rejection compared well with other indications (38.1%); CsA: 40.1% versus 33.3% in FK506 patients. In all, 18.2% of CsA patients experienced steroid-resistant rejection compared with 2.6% of FK506 patients. Seven patients (7.6%) in the CsA group and one patient (1.3%) in the FK506 group developed chronic rejection. A total of 57.1% developed infections; 5.7% were life-threatening. CMV infections were observed in 14.3% (versus 25% for other indications). New onset of insulin-dependent diabetes was observed in 8.6% and hypertension in 32.4%. In conclusion, alcoholic cirrhosis is a good indication for liver transplantation with respect to graft and patient survival and development of postoperative complications. FK506 therapy was favourable to CsA treatment. Patient selection is a major issue and established criteria should be strictly adhered to. Patients with alcohol abstinence times shorter than 6 months should be excluded, since recurrence and death due to recurrence was markedly increased in this group of patients.
K P Platz, and
A R Mueller, and
E Spree, and
G Schumacher, and
N C Nüssler, and
N Rayes, and
M Glanemann, and
W O Bechstein, and
P Neuhaus
May 1989,
JAMA,
K P Platz, and
A R Mueller, and
E Spree, and
G Schumacher, and
N C Nüssler, and
N Rayes, and
M Glanemann, and
W O Bechstein, and
P Neuhaus
April 1998,
Journal of clinical gastroenterology,
K P Platz, and
A R Mueller, and
E Spree, and
G Schumacher, and
N C Nüssler, and
N Rayes, and
M Glanemann, and
W O Bechstein, and
P Neuhaus
November 1988,
JAMA,
K P Platz, and
A R Mueller, and
E Spree, and
G Schumacher, and
N C Nüssler, and
N Rayes, and
M Glanemann, and
W O Bechstein, and
P Neuhaus
January 1994,
Gastroenterologie clinique et biologique,
K P Platz, and
A R Mueller, and
E Spree, and
G Schumacher, and
N C Nüssler, and
N Rayes, and
M Glanemann, and
W O Bechstein, and
P Neuhaus
May 1993,
La Revue du praticien,
K P Platz, and
A R Mueller, and
E Spree, and
G Schumacher, and
N C Nüssler, and
N Rayes, and
M Glanemann, and
W O Bechstein, and
P Neuhaus
April 1992,
Schweizerische medizinische Wochenschrift,
K P Platz, and
A R Mueller, and
E Spree, and
G Schumacher, and
N C Nüssler, and
N Rayes, and
M Glanemann, and
W O Bechstein, and
P Neuhaus
August 1998,
Hospital medicine (London, England : 1998),
K P Platz, and
A R Mueller, and
E Spree, and
G Schumacher, and
N C Nüssler, and
N Rayes, and
M Glanemann, and
W O Bechstein, and
P Neuhaus
March 2014,
Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society,
K P Platz, and
A R Mueller, and
E Spree, and
G Schumacher, and
N C Nüssler, and
N Rayes, and
M Glanemann, and
W O Bechstein, and
P Neuhaus
January 1997,
Transplantation proceedings,
K P Platz, and
A R Mueller, and
E Spree, and
G Schumacher, and
N C Nüssler, and
N Rayes, and
M Glanemann, and
W O Bechstein, and
P Neuhaus
September 1999,
Transplantation proceedings,
