Nation-Wide Survey of Living Donor Liver Transplantation for Alcoholic Liver Cirrhosis in Japan, A
Surgery, Tokyo Women's Medical University, Tokyo, Japan
Psychiatry, Tokyo Women's Medical University, Tokyo, Japan
Meeting: 2013 American Transplant Congress
Abstract number: B1082
Alcoholic liver cirrhosis (ALC) is one of established indications for liver transplantation (LT). Six month rule is the most popular selection criteria and High-Risk Alcohol Relapse (HRAR) scale is debated. Existence of a living donor (LD) might have favorable effects to prevent relapse. Aim of this study is to evaluate risk factors for relapse and its impact on outcome. Patients and Methods: From November 1997 to December 2011, 195 patients (25–69 year old, 69 males and 126 females) underwent LT in Japan. Outcome and alcohol relapse were assessed using patients’ records, laboratory tests and interviews. Donors were 61 sons/daughters, 29 siblings, 30 spouses, 6 parents, 3 nephews, 2 brothers in law, 1 cousin, 1 nephew in law, 2 domino donors, and 5 deceased donors. This multicenter study was approved by the institutional IRB. Results: Follow-up period was 160 days to 4962 days. Relapse rate (RR) in 140 patients was analyzed, after excluding 26 patients with hospital mortality after LT and 29 patients without information of relapse. Patients with abstinence longer than 6 months (19% vs. 28%), discontinuing smoking (14% v s 33%), and living with family (22% vs. 44%) prior to LT had a tendency for lower RR (ns). RR after LT from grafts from parents (50%), siblings (35%), nephews (33%) were higher than from spouses (13%), sons/daughters (20%), and decreased or domino donors (14%). Postoperative smoking was a significant risk (46% vs. 16%, p<0.05). Solitude (50% vs. 16%), visiting noncompliance (50% vs. 21%), unmarried life (60% vs. 23%) after LT were possible risks (not significant). Living with the donor and working condition had no impact on RR. HRAR score had no relation with RR (32% in score 1, 20% in score 2, 25% in score 3, 11% in score 4). MELD score greater than 19 (5 year patient survival; 72% vs. 82%), donor age greater than 50 years (5 year patient survival; 68% vs. 78%), and liver dysfunction relating to relapse (5 year patient survival; 73% vs. 93%) were significant risks for patient survival (p<0.05). Conclusions: Abstinence, discontinuing smoking and family support is important in LT for ALC. Establishment of a socio-medical support system is required in Japan.
To cite this abstract in AMA style:
Egawa H, Nishimura M, Yamamoto M. Nation-Wide Survey of Living Donor Liver Transplantation for Alcoholic Liver Cirrhosis in Japan, A [abstract]. Am J Transplant. 2013; 13 (suppl 5). https://atcmeetingabstracts.com/abstract/nation-wide-survey-of-living-donor-liver-transplantation-for-alcoholic-liver-cirrhosis-in-japan-a/. Accessed November 22, 2024.« Back to 2013 American Transplant Congress