Liver Transplantation for Alcohol-related Liver Disease: Where Do We Stand

Dear Colleagues,

Alcohol-related liver disease (ALD) is a major indication for liver transplantation worldwide. Outcomes for patients transplanted for ALD are excellent and comparable to other indications, with a 5-year survival rate of approximately 75–86%. However, liver transplantation for ALD still generates a great deal of discussion due to the perception that ALD is self-inflicted and concerns regarding alcohol relapse after transplantation. Traditionally, most transplant centers require a 6-month period of abstinence before considering a patient with ALD suitable for liver transplantation, though both American and European guidelines state that the 6-month rule should no longer be used to assess whether a patient can be accepted as a liver transplantation candidate. Specifically, early liver transplantation may be indicated without 6 months of abstinence when liver function deteriorates rapidly, including in patients with severe alcoholic hepatitis at their first episode of severe decompensation with no response to steroid therapy or to other medical treatments. In such patients, post-transplant outcomes are excellent, with survival rates that are significantly higher when compared with patients not responding to medical therapy and not transplanted. The need for multidisciplinary assessment to evaluate candidates for liver transplantation for both alcohol-related cirrhosis and severe acute alcoholic hepatitis is increasing.

The aim of this Special Issue is to address the multiple aspects of ALD as potential indication for liver transplantation, highlighting the most recent advances regarding the optimal management of ALD candidates and transplant recipients.

Prof. Dr. Patrizia Burra
Dr. Alberto Zanetto
Guest Editor

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• alcohol
• liver transplantation
• cirrhosis
• alcohol-related liver disease
• hepatocellular carcinoma
• 6-month rule
• alcoholic hepatitis
• survival