Introduction: Alcoholic liver cirrhosis is a common indication for liver transplantation. In spite of strict patients’ selection a recurrence of alcohol abuse is seen in 10–50% patients. The aim of our retrospective study is an evaluation of the course of treatment after transplantation in recipients with regards to alcohol abuse. Patients and methods: During period from October 1995 till February 2002 246 orthotopic liver transplantation was carried out in our institution (IKEM) included 42 (17.1%) patients suffering from alcoholic liver cirrhosis. Only patients followed-up at least one year were included. Liver biopsy according to the protocol was carried out 1, 2, 3, 5 and 7 years after liver transplantation. As a recurrence of alcoholic abuse we considered any remark about alcohol consumption according to a questionnaire. The obtained results we compared to laboratory tests for alcohol abuse and semiquantitatively evaluated results of liver biopsy of the graft. We compared the survival of patients and grafts in the mentioned groups after 1, 3 and 5 years after transplantation (Kaplan-Meier test) and evaluated the basic sociology data (education, divorce rate, smoking). Results: Sixteen from 42 (38%) recipients confessed alcohol abuse. In 4 patients the alcohol abuse was followed by graft failure. 2 patients died from liver failure. One patient with marked alcohol abuse refused a haemodialysis and died for renal failure. 12 patients returning to their alcohol abuse without detectable dysfunction of a liver graft. In the group with alcohol abuse very often steatosis and Mallory’s hyalin appeared (56.25% resp. 18.75%, p < 0.05). In liver fibrosis any difference was not seen. Among recipients with declared alcohol consumption and a group which declared an abstention from alcohol we found a diference in BMI value (25.40 ± 3.33 vs. 27.83 ± 3.85, p < 0.04), triacyglycerol value (3.73 ± 2.07 vs 2.36 ± 1.76, p < 0.04), MCV (97.49 ± 7.02 vs 87.69 ± 3.14, p < 0.0004), GMT activity (4.48 ± 6.96 vs 0.79 ± 1.17, p < 0.05), smoking (p < 0.05) and sex (p < 0.05). In education and divorce rate we did not see any difference. One, three and 5 years survival rate in the group of declared alcohol abuse against patients with alcohol abstention was significantly lower (100 %, 83 %, 74 % vs 100 %, p < 0.05). Conclusions: Patients after orthotopic liver transplantation for alcoholic liver cirrhosis with declared recurrence of alcohol abuse have lower survival rate in comparison with patients declared alcohol abstention. A questionnaire looks like a suitable way for detection of alcohol abuse recurrence after liver transplantation according to significant difference in histology findings and laboratory tests between both groups. Recurrence of alcohol abuse can be fatal. Its occurrence in our group is similar to published papers.

        Key words: liver transplantation – alcohol abuse – alcoholic liver cirrhosis