YIS-3A RETROSPECTIVE STUDY COMPARING SURVIVAL, RECIDIVISM AND COMPLICATIONS AFTER LIVER TRANSPLANTATION IN PATIENTS WITH ALCOHOLIC AND HCV-RELATED CIRRHOSIS

Abstract

Background and aim: Alcohol represents the most common cause of liver cirrhosis in the Western countries. Total alcohol abstinence represents the cornerstone in the management of alcoholic cirrhosis (AC). When liver function fails to improve with abstinence, liver transplantation (LT) is the treatment of choice. However LT in patients with AC remains controversial for the risk of alcohol recidivism after LT, and the perception of AC as a "self-inflicted disease". Actually, HCV-related cirrhosis is the leading indication for LT. The aim of this study was to evaluate the differences in terms of survival, recidivism and complications between patients who underwent LT for AC and HCV-related cirrhosis. Material(s) and Method(s): A total of 297 patients who underwent LT at the Gemelli Hospital from 1995 to 2010 were retrospectively evaluated. In par ticular 66 (22.2%) patients underwent LT for alcoholic cirrhosis, and 52 (17.5%) patients for HCV-related cirrhosis. The survival rate was evaluated according to the Kaplan-Meier model. Recidivism for patients with AC was defined as any alcohol intake after LT. Recidivism for HCV-related cirrhosis was defined as histological evidence of chronic hepatitis C within3 years of LT. Moreover post-surgery complications, chronic and acute rejection, onset of cancer, infectious, cardiovascular and metabolic disease was evaluated. Result(s): Patients who underwent LT for AC showed a higher, however not significant, rate of survival than patients who underwent LT for HCV-related cirrhosis. Patients with HCV-related cirrhosis showed a significant higher prevalence of recidivism after LT (p=0.02). Patients transplanted for AC presented a significantly higher prevalence of cancer, in particular of upper digestive tract (p=0.04). No differences were found in the prevalence of cardiovascular, metabolic and infectious disease, rejection, and post-surgery complications between the two groups. Conclusion(s): This study shows that our patients who underwent LT for AC have a higher survival rate and a lower recidivism rate than patients who underwent LT for HCV-related cirrhosis. No differences in terms of complications after LT were found between two groups, with the except of the higher prevalence of cancer in the AC group. These data are in line with previous literature data.