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World J Hepatol. Nov 27, 2014; 6(11): 812-817
Published online Nov 27, 2014. doi: 10.4254/wjh.v6.i11.812
Perceptions of post-transplant recidivism in liver transplantation for alcoholic liver disease
Yoshikuni Kawaguchi, Yasuhiko Sugawara, Nobuhisa Akamatsu, Junichi Kaneko, Tomohiro Tanaka, Sumihito Tamura, Taku Aoki, Yoshihiro Sakamoto, Kiyoshi Hasegawa, Norihiro Kokudo
Yoshikuni Kawaguchi, Yasuhiko Sugawara, Nobuhisa Akamatsu, Junichi Kaneko, Sumihito Tamura, Taku Aoki, Yoshihiro Sakamoto, Kiyoshi Hasegawa, Norihiro Kokudo, Artificial Organ and Transplantation Surgery Division, Department of Surgery, Graduate School of Medicine, University of Tokyo, Tokyo 113-0033, Japan
Tomohiro Tanaka, Organ Transplantation Service, University of Tokyo, Tokyo 113-0033, Japan
Author contributions: All authors contributed to this paper.
Supported by A Grant-in-aid for Scientific Research from the Ministry of Education, Culture, Sports, Science and Technology of Japan and from the Ministry of Health, Labor and Welfare of Japan (AIDS Research)
Correspondence to: Yasuhiko Sugawara, MD, Artificial Organ and Transplantation Surgery Division, Department of Surgery, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan. yasusugatky@yahoo.co.jp
Telephone: +81-3-38155411 Fax: +81-3-56843989
Received: May 8, 2014
Revised: August 27, 2014
Accepted: September 16, 2014
Published online: November 27, 2014
Processing time: 196 Days and 3.5 Hours
Abstract

Although alcoholic liver disease (ALD) is regarded as a common indication for liver transplantation (LT), debatable issues exist on the requirement for preceding alcoholic abstinence, appropriate indication criteria, predictive factors for alcoholic recidivism, and outcomes following living-donor LT. In most institutions, an abstinence period of six months before LT has been adopted as a mandatory selection criterion. Data indicating that pre-transplant abstinence is an associated predictive factor for alcoholic recidivism supports the reasoning behind this. However, conclusive evidence about the benefit of adopting an abstinence period is yet to be established. On the other hand, a limited number of reports available on living-donor LT experiences for ALD patients suggest that organ donations from relatives have no suppressive effect on alcoholic recidivism. Prevention of alcoholic recidivism has proved to be the most important treatment after LT based on the resultant inferior long-term outcome of patients. Further evaluations are still needed to establish strategies before and after LT for ALD.

Keywords: Abstinence; Alcoholic liver disease; Liver transplantation; Six-month rule

Core tip: Prevention of alcoholic recidivism has proved to be the most important treatment after liver transplantation based on inferior long-term outcome of patients. Further evaluations, however, are still needed to establish strategies before and after liver transplantation with alcoholic liver diseases.