Low Incidence of Alcohol Relapse following Living Donor Liver Transplantation

Abstract

Abstract Background Alcohol relapse after liver transplantation has a negative impact on outcomes. There is limited data on its burden, the predictors, and the impact following live donor liver transplantation (LDLT). Methods A single-center observational study was carried out between July 2011 and March 2021 for patients undergoing LDLT for Alcohol associated liver disease (ALD). The incidence, predictors of alcohol relapse, and post-transplant outcomes were assessed. Results Altogether 720 LDLT were performed during the study period, 203 (28.19%) for ALD. The overall relapse rate was 9.85% (n = 20) with a median follow-up of 52 months (range, 12-140 months). Sustained harmful alcohol use was seen in 4 (1.97%). On multivariate analysis, pre-LT relapse (p=0.001), duration of abstinence less than 3 months (p=0.007), daily intake of alcohol (p=0.001), absence of life partner (p=0.021), concurrent tobacco abuse before transplant (p=0.001), the donation from second-degree relative (p=0.003) and poor compliance with medications (p=0.001) were identified as predictors for relapse. Alcohol relapse was associated with the risk of graft rejection (HR 4.54,95% CI 1.751–11.80, p = 0.002). Conclusion Our results show that the overall incidence of relapse and rate of harmful drinking following LDLT is low. Donation from spouse and first degree relative was protective. History of daily intake, prior relapse, pre-transplant abstinence of less than three-months duration and lack of family support significantly predicted relapse.