Liver transplantation for alcoholic liver disease : a retrospective analysis of recidivism, survival and risk factors predisposing to alcohol relapse

Background and study aims : Alcoholic liver disease (ALD) is the second most common indication for liver transplantation. The aim of this study was to evaluate the alcohol relapse rate and long-term survival after liver transplantation for ALD and to identify risk factors predisposing to alcohol relapse. Patients and methods : Between 2000 and 2007, 108 patients transplanted for ALD in the Ghent University Hospital were in- cluded in this retrospective analysis. Relapse was defined as any drinking after transplantation, problem drinking as more than 2 units/day for women and 3 units/day for men. A wide range of variables was obtained from a questionnaire and medical records. Results : The mean follow-up was 55 months. Relapse was ob- served in 29%, 16% in problem drinking. The one- and five-year survival was 87% and 74% respectively. No significant difference in survival was found between non-relapsers, occasional drinkers and problem drinkers. The following risk factors were found to be significantly associated with relapse into problem drinking in an univariate analysis : a shorter pre-transplant abstinence period, the presence of a first degree relative with alcohol abuse and a high- er number of prior attempts to quit. In multivariable analysis, the presence of a first degree relative with alcohol abuse was found as- sociated with relapse into problem drinking. Conclusions : The presence of a first degree relative with alcohol abuse is a valuable pre-transplant variable evaluating an ALD pa- tient's eligibility for liver transplantation. Other variables are also helpful to outline the broader context of the drinking behavior of the patient. (Acta gastroenterol. belg., 2013, 76, 282-290).