Background: Alcohol is amongst the leading causes of liver disease worldwide. Most centers have a 6-month abstinence requirement before transplantation candidacy. Mortality rates for acute alcoholic liver decompensation approaches 80%. Liver transplantation has recently been recommended for selected patients with alcoholic hepatitis (AH). We aimed to review a single-center experiences of recipients with underlying liver disease presenting with acute decompensation who were actively drinking within 6-months prior to transplant

Methods: Retrospective review of 306 consecutive adult who underwent liver transplant (OLT) between June 2011 and June 2015. We identified OLT recipients who were listed and transplanted within 60-days for acute alcohol related liver decompensation. Candidacy was determined for these patients under our institutional policy. Post-transplant recipients had direct face to face counselling to identify recidivism. Family members were also separately questioned about patient's sobriety. Primary end points were patient survivals. Recidivism was characterized as a slip or problematic drinking.

Results: A total of 37 (12%) patients were analyzed with median days on the list 10 ( 0-56). Median age was 46 (21-76), 21 (57%) were male, and 27 (73%) were Caucasian. At time of transplant, median bio-MELD score was 36 ( 20-45) and median SIPAT score was 32 (17-59).Thirty four (92%) of recipients were transplanted from ICU, and 25(68%) were on ventilator.. Median follow-up was 17-months, with one and 3- year survival rates of 100% and 95% consecutively. Alcohol relapse was noticed in 9 recipients (24%), [3(8%) Slip and 6 (16%) problematic], graft function was not different when compared to patients without recidivism, (p=NS).

Conclusions: Patients with acute alcoholic liver decompensation and actively drinking achieved excellent outcomes post-liver transplantation. Post-transplant recidivism rates were in line with prior series of patients who achieved traditional sobriety goals. Selected patients presenting with acute alcohol related liver decompensation who have not met the 6-month sobriety threshold benefit from liver transplantation.

CITATION INFORMATION: Monsour H, Victor D, Boktour M, Galati J, Ontiveros J, Theriot L, McFadden R, Mobley C, Saharia A, Gordon-Burroughs S, Gaber A, Ghobrial R. Liver Transplantation in Patients Actively Drinking Less Than 6 Months Before Transplant Presenting with Acute Decompensation: A Single-Center Experience. Am J Transplant. 2016;16 (suppl 3).

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