Liver Transplantation in Patients with Alcohol-Associated Liver Disease: Current Strategies and Future Perspectives

Abstract

Patients with alcohol-related liver disease (ALD) who receive a liver transplant (LT) reach a one-year post LT survival of 80–85%. The rule of abstinence from alcohol for 6 months before transplantation has been applied widely, but few data support the use of this rule as the only criterion for selecting LT candidates. Today, many liver transplant centers try to balance the duration of abstinence against the risk of death associated with the severity of ALD. Since 2011, an increasing number of papers suggests that transplantation without a specific period of abstinence (early LT) among patients with severe and nonmedical-therapy responder alcoholic hepatitis is an effective therapeutic strategy. Further data are needed to better define the selection of patients with ALD who have been abstinent for less than 6 months as suitable LT candidates and to improve the treatment of alcohol use disorder in those patients who have received a LT reducing the risk of alcohol abuse recurrence.