Skipping the recommended six-month “dry out” period for alcoholics in need of a new liver, before performing a liver transplant, results in better survival rates, according to a study published in this week’s New England Journal of Medicine.
Currently, patients with severe alcoholic hepatitis are required to abstain from drinking for six months before they are eligible for a liver transplant. However, many patients are at risk of dying during that period. Patients whose hepatitis does not respond to medical treatment have a six-month survival rate of 30 percent, and most alcoholic hepatitis deaths occur within two months, HealthDay reports.
The study found 77 percent of recovering alcoholics given transplants about two weeks after their first episode of severe alcoholic hepatitis were alive six months later, compared with 23 percent who didn’t receive early transplants.
The 26 patients selected to receive transplants before the six-month waiting period had supportive family members, no other severe medical conditions, and a commitment to alcohol abstinence. Of these patients, six died shortly after surgery. Three patients began drinking again—two after two years, and one after more than three years.
In an editorial accompanying the study, Dr. Robert S. Brown, Jr. of Columbia University College of Physicians and Surgeons’ Center for Liver Disease and Transplantation says liver transplantation for alcoholic liver disease has been controversial because of the perception that alcohol-related liver disease is self-inflicted. He adds there are concerns that patients will return to drinking and not adequately take care of themselves after the transplant. Dr. Brown urged the six-month no-drinking rule be reconsidered.
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