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Acute alcoholic hepatitis, end stage alcoholic liver disease and liver transplantation: An Italian position statement
Alcoholic liver disease encompasses a broad spectrum of diseases ranging from steatosis steatohepatitis,fibrosis,and cirrhosis to hepatocellular carcinoma.Forty-four per cent of all deaths from cirrhosis are attributed to alcohol.Alcoholic liver disease is the second most common diagnosis among pati...
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Published in: | World journal of gastroenterology : WJG 2014-10, Vol.20 (40), p.14642-14651 |
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Main Authors: | , , , , , , , , , , , , , , , , , , , , , , , |
Format: | Article |
Language: | English |
Subjects: | |
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Online Access: | Get full text |
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Summary: | Alcoholic liver disease encompasses a broad spectrum of diseases ranging from steatosis steatohepatitis,fibrosis,and cirrhosis to hepatocellular carcinoma.Forty-four per cent of all deaths from cirrhosis are attributed to alcohol.Alcoholic liver disease is the second most common diagnosis among patients undergoing liver transplantation(LT).The vast majority of transplant programmes(85%)require 6 mo of abstinence prior to transplantation;commonly referred to as the"6-mo rule".Both in the case of progressive end-stage liver disease(ESLD)and in the case of severe acute alcoholic hepatitis(AAH),not responding to medical therapy,there is a lack of evidence to support a 6-mo sobriety period.It is necessary to identify other risk factors that could be associated with the resumption of alcohol drinking.The"Group of Italian Regions"suggests that:in a case of ESLD with model for end-stage liver disease<19 a 6-mo abstinence period is required;in a case of ESLD,a 3-mo sober period before LT may be more ideal than a 6-mo period,in selected patients;and in a case of severe AAH,not respond-ing to medical therapies(up to 70%of patients die within 6 mo),LT is mandatory,even without achieving abstinence.The multidisciplinary transplant team must include an addiction specialist/hepato-alcohologist.Patients have to participate in self-help groups. |
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ISSN: | 1007-9327 2219-2840 |
DOI: | 10.3748/wjg.v20.i40.14642 |