Long-term outcome of living donor liver transplantation for patients with alcoholic liver disease

Background: Because most liver transplantation (LT) studies for alcoholic liver disease (ALD) were performed on deceased donor LT, little was still known following living donor LT (LDLT).

Methods: The clinical outcomes of 126 ALD patients who underwent LDLT for 11 years in a high-volume LT center were assessed retrospectively.

Results: ALD cases were 5.7% of adult LDLT indication (n = 2196). ALD was 1.9% (4 of 207) during 2000 to 2001, whereas the proportion gradually increased up to 11.3% (34 of 301) in 2010. The model for end-stage liver disease score was 22.1 ± 9.9, and 6-month abstinence was observed in 105 (83.3%). There were 123 (97.6%) related donors. Single-graft and dual-graft were implanted into 111 and 15 patients, respectively. Main graft type was single right liver graft (n = 108; 85.7%). Graft-to-recipient weight ratio was 1.02 ± 0.16. Perioperative mortality within 3 months occurred in 5 (4.0%). Overall 1-, 3-, 5-, and 10-year patient survival rates were 92.1%, 88.0%, 85.8%, and 83.7%, respectively. Three patients died of alcohol abuse. De novo hepatitis B virus infection occurred in 2 of 26 patients after implantation of core antibody-positive graft and no further cases happened after strict application of prophylaxis.

Conclusions: The results of this study revealed that the survival outcome of LDLT in ALD patients is comparable with that of deceased donor LT. To achieve favorable long-term survival, a multidisciplinary approach can be an effective strategy, including the interaction between the patient, the physician, and the family members.