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Liver transplantation for alcoholic hepatitis: A systematic review with meta-analysis.

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Marot, Astrid [UCL] Dubois, Margaux Trépo, Eric Moreno, Christophe Deltenre, Pierre

(eng) BACKGROUND: The rate of alcohol relapse among patients who underwent liver transplantation for alcoholic hepatitis (AH) is not precisely known. AIM: Synthesize the available evidence on liver transplantation for AH to assess alcohol relapse and 6-month survival. METHODS: Meta-analysis of trials evaluating liver transplantation for AH, either clinically severe or diagnosed on the explant. RESULTS: Eleven studies were included. The pooled estimate rate for alcohol relapse was 0.22 (95% CI = 0.12-0.36) in overall analysis with high heterogeneity between studies (I2 = 76%), 0.20 (95% CI = 0.07-0.43) in the subgroup analysis including patients with clinically severe AH (I2 = 84%), 0.14 (95% CI = 0.08-0.23) among patients with clinically severe AH in sensitivity analysis excluding the discrepant studies that did not use stringent selection criteria for liver transplantation (I2 = 0%), and 0.15 (95% CI = 0.07-0.27) for recurrent harmful alcohol consumption among patients with clinically severe AH (I2 = 3%). The risk of alcohol relapse was not different between AH transplanted patients and patients with alcoholic cirrhosis who underwent elective liver transplantation in sensitivity analysis excluding the discrepant studies (OR = 1.68, 95%CI = 0.79-3.58, p = 0.2, I2 = 16%). The pooled estimate rate for 6-month survival was 0.85 (95% CI = 0.77-0.91, I2 = 49%), and 0.80 among patients transplanted for clinically severe AH (95% CI = 0.69-0.88, I2 = 30%). AH transplanted patients had similar 6-month survival to patients with alcoholic cirrhosis who underwent elective liver transplantation (OR = 2.00, 95% CI = 0.95-4.23, p = 0.07, I2 = 0%). CONCLUSION: Using stringent selection criteria, 14% of patients with clinically severe AH have alcohol relapse after liver transplantation. The percentage of alcohol relapse of AH transplanted patients is similar than that of patients who underwent elective liver transplantation.

Document type Article de périodique (Journal article) – Article de recherche
Access type Accès libre
Publication date 2018
Language Anglais
Journal information "PLoS One" - Vol. 13, no. 1, p. e0190823 [1-14] (2018)
Peer reviewed yes
Publisher Public Library of Science ((United States) San Francisco, CA)
e-issn 1932-6203
Publication status Publié
Affiliations UCL - (MGD) Service de gastro-entérologie
UCL - SSS/IREC/MONT - Pôle Mont Godinne
MESH Subject Alcohol Abstinence ; Alcoholism ; Elective Surgical Procedures ; Hepatitis, Alcoholic ; Humans ; Liver Transplantation ; Recurrence
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Bibliographic reference Marot, Astrid ; Dubois, Margaux ; Trépo, Eric ; Moreno, Christophe ; Deltenre, Pierre. Liver transplantation for alcoholic hepatitis: A systematic review with meta-analysis.. In: PLoS One, Vol. 13, no. 1, p. e0190823 [1-14] (2018)
Permanent URL http://hdl.handle.net/2078.1/212593