Date: Saturday, May 30, 2020
Session Time: 3:15pm-4:00pm
Presentation Time: 3:30pm-4:00pm
*Purpose: Liver transplants (LT) for acute alcoholic hepatitis (AH) have become more common but there is limited data about outcomes of LT as therapy for AH. Our goal was to compare 30-day and 1-year morbidity in AH and alcoholic cirrhosis (AC) patients after LT. We compared 37 perioperative variables (Table 1).
*Methods: Overall findings were summarized as median and minimum-maximum values or proportions. Comparisons between groups were made using Mann-Whitney U test, Pearson’s chi-squared or Fisher’s exact test as appropriate. Multivariable analysis was done using logistic regression to identify factors independently associated with outcomes.
*Results: AH patients were younger, with higher MELD scores and worse Karnofsky scores (p< 0.05). AH patients had a higher 30-day reoperation rate and higher moderate-severe steatosis on explant (P< 0.05). Only age and Karnofsky score remained significant on multivariate analysis (p< 0.05). One-year interventions, vascular and biliary complications, graft and patient survival, ICU-LOS or total LOS, and intraoperative features were similar (p>0.05). Although AH patients had higher rates of alcohol relapse (40% vs.17%), 1-year infection (87% vs.62%) and 1-year rejection rates (40% vs.22%), none of these reached statistical significance (p>0.05).
*Conclusions: AH patients are younger with higher MELD scores and worse functional status compared to AC patients. AH patients had significantly higher 30-day reoperation rates, perhaps reflecting difficulty of transplant surgery in the AH population, but otherwise had similar 1-year survival, surgical complication and intervention rates. AH patients had higher alcohol relapse causing graft damage and higher 1-year infection and rejection rates but neither reached statistical significance. A larger cohort is necessary to confirm the power of these findings
To cite this abstract in AMA style:Andacoglu OM, Ozbek U, Liu J, Figueredo C, Chacko KR, Tow C, Reinus JF, Kinkhabwala M. Comparison of One-Year Morbidity Following Liver Transplant for Acute Alcoholic Hepatitis vs. Alcoholic Cirrhosis [abstract]. Am J Transplant. 2020; 20 (suppl 3). https://atcmeetingabstracts.com/abstract/comparison-of-one-year-morbidity-following-liver-transplant-for-acute-alcoholic-hepatitis-vs-alcoholic-cirrhosis/. Accessed March 8, 2021.
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