Standardising early liver transplantation for severe alcohol-related hepatitis

Abstract

In the QuickTrans study 1 Louvet A Labreuche J Moreno C et al. Early liver transplantation for severe alcohol-related hepatitis not responding to medical treatment: a prospective controlled study. Lancet Gastroenterol Hepatol. 2022; 7: 416-425 Summary Full Text Full Text PDF Scopus (9) Google Scholar —the first truly controlled trial of early liver transplantation for patients with severe alcohol-related hepatitis not responding to medical treatment compared with standard liver transplantation for patients with alcohol-related cirrhosis and severe alcohol-related hepatitis not responding to medical treatment ineligible for early liver transplantation—Alexandre Louvet and colleagues demonstrated an absence of non-inferiority in alcohol relapse between the liver transplantation groups, but equivalent 2-year survival, and proposed a new candidate selection algorithm for early liver transplantation. Early liver transplantation for severe alcohol-related hepatitis not responding to medical treatment: a prospective controlled studyWe cannot conclude non-inferiority in terms of rate of alcohol relapse post-transplant between early liver transplantation and standard transplantation. High alcohol intake is more frequent after early liver transplantation. This prospective controlled study confirms the important survival benefit related to early liver transplantation for severe alcohol-related hepatitis; and this study provides objective data on survival and alcohol relapse to tailor the management of patients with severe alcohol-related hepatitis. Full-Text PDF Standardising early liver transplantation for severe alcohol-related hepatitis – Authors' replyWe thank Gene Im for his comments. Some clarifications are needed to avoid misunderstanding. In our study, any medical history of life-threatening events with a hospital stay, such as liver decompensation, delirium tremens, or acute pancreatitis would have led to the non-selection of the patient. We apologise for the incorrect transcription of the scoring item “Past medical history of liver decompensation”—this text was retained for methodological reasons because it appeared on the original ClinicalTrials.gov registration. Full-Text PDF