Research backs earlier liver transplants for some alcoholic hepatitis patients

Certain patients with severe alcoholic hepatitis should be considered for earlier liver transplantation without the customary 6-month sobriety requirement, researchers said.

A study examined patients with no prior episodes of alcoholic hepatitis who had Lille model scores of 0.45 or higher or rapid decrease in liver function despite therapy. Each member of the 26-patient study group also had a supportive family, a commitment to alcohol abstinence and no severe coexisting conditions.

Researchers then compared survival rates between those patients who received early liver transplantation and matched patients who complied with the customary sobriety period.

Patients who received early transplantation achieved a higher cumulative 6-month survival rate (77 ± 8%) compared with those who did not (23 ± 8%). After 2 years of follow-up, the early transplantation benefit was maintained (HR=6.08; P=.004). Three patients failed to maintain abstinence from alcohol.

“The high risk of early death in patients with severe alcoholic hepatitis not responding to medical therapy makes it necessary to consider all available treatment options, including transplantation, in targeted patients,” the study authors said.

Disclosure: The researchers report no relevant financial disclosures.