CZECH MEDICAL ASSOCIATION J. Ev. PURKYNĚ | |
Journals - Article | |
Česky / Czech version | Čes. a Slov. Gastroent., 55, 2001, No. 3, p. 104-106 |
Selection of Patients with Alcoholic Cirrhosis
of the Liver for Liver Transplantation in the Institute for Clinical
and Experimental Medicine (IKEM) Wohl P., Kostolná E., Šperl J., Hrneárková H., Štirand P., Klinika hepatogastroenterologie, IKEM, Praha, Klinika transplantaèní chirurgie, IKEM, Praha, Transplantcentrum, IKEM, Praha |
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Summary: Introduction: The number of patients indicated for transplantation of the liver on account of alcoholic cirrhosis is rising. The selection of alcoholics on the waiting list is subject to specific criteria which should reduce to
a minimum the risk of relapse of alcoholism. The objective of the present paper is the selection and inclusion
of patients with alcoholic liver cirrhosis in the waiting list and the results of their treatment four years after
initiation of the programme of liver transplantations in IKEM.
Patients: Of 616 patients examined and considered for liver transplantation 176 suffered from alcoholic
cirrhosis and 440 from cirrhosis with a different etiology.
Results: Of 176 patients with alcoholic liver cirrhosis 30 (17%) were included on the waiting list while from
the remaining 440 cirrhoses with a different etiology 166 (37.7%) were included (p < 0.001). From April 1995
till October 1999 154 transplantations of the liver were made with a total one-year survival of 88% (Kaplan-
Meir). Of 26 patients with transplantations on account of alcoholic cirrhosis six resumed regular alcohol
consumption. Two cases can be described as relapses of alcoholism, one died from hepatic failure associated
with alcoholic cirrhosis of the graft and the second lives with confirmed steatofibrosis of the graft. From the
group of alcohol addicts another two died for reasons unrelated to alcohol. Of 38 patients with transplantations on account of cholestatic cirrhosis three died and from the group with viral hepatitis C 8 died. The
difference in deaths among patients with alcoholic cirrhosis and posthepatitic cirrhosis C is statistically
significant (p < 0.05).
Conclusion: Patients with alcoholic liver cirrhosis have roughly a 50% chance of being placed on the waiting
list in IKEM which is due to strict selection criteria. The relapse of alcoholism in the authors´ group is
comparable with data from other world centres. The results of transplantation treatment in alcoholic cirrhosis
are favourable.
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