Clinical characteristics and survival analysis of liver transplantation in patients with alcoholic liver disease: A single-center retrospective study

Abstract

ObjectiveBy reviewing the clinical data of liver transplantation in the treatment of alcoholic liver disease in a single center and analyzing the clinical characteristics, the long-term prognosis and main risk factors for early postoperative death were investigated. MethodsThe clinical data of 98 cases of orthotopic liver transplantation performed due to alcoholic liver disease were collected to explore the effect on survival following liver transplants. The patients had been treated in the Organ Transplantation Center of the Tianjin First Central Hospital from November 2011 to November 2020. ResultsThe follow-up duration was 1–108 months. Nine cases died; among these cases, three died during the perioperative period. Univariate analysis revealed that daily ethanol intake, Model for End-Stage Liver Disease (MELD) scores, and preoperative liver failure were associated with perioperative death, and multivariate analysis revealed that daily ethanol intake was an independent risk factor for perioperative death (P = 0.048 < 0.05); the daily intake of ethanol in the death group was significantly higher than that in the survival group (293 ± 11.5 g vs. 178.3 ± 66.8 g, P = 0.004 < 0.05). Six patients died during long-term follow-up. The one-, five-, and nine-year cumulative survival rates were 96.8%, 92.0%, and 92.0%, respectively. Preoperative liver cancer was the main risk factor for long-term survival (ORR = 2884.3, P = 0.041 < 0.05). The primary cause of death was recurrence of malignant liver tumors, followed by new lung malignancies, intracerebral hemorrhage, and hepatic allograft dysfunction. ConclusionAlcoholic liver disease is a good indication for liver transplantation. Heavy daily drinking before an operation increases the risk of perioperative death. Recurrence of malignant liver tumors is the main risk factor affecting long-term survival.