Korean J Transplant.  2023 Nov;37(Suppl 1):S260. 10.4285/ATW2023.F-8572.

The impact of alcohol relapse after liver transplantation in patients with alcoholic liver disease

• Kang EJ
• Lee Y
• Hong S

• KMID: 2551889
• DOI: http://doi.org/10.4285/ATW2023.F-8572

Abstract

Background
According to the National Institute of Organ Tissue Blood Management Institute, while liver transplants due to viral liver diseases are decreasing, those due to alcoholic liver disease are on the rise. Additionally, the issue of posttransplant alcohol relapse in patients who have undergone liver transplantation for alcoholic liver disease has become a concern. This study aims to investigate the rate of alcohol relapse and its impact on post-transplant outcomes.
Methods
We analyzed medical records of 238 patients out of 271 who underwent liver transplantation for alcoholic liver disease at Samsung Medical Center from June 2016 to January 2023, who followed-up at least 6 months posttransplantation.
Results
Among the 238 participants, 92 (38.7%) had deceased donor liver transplantation (DDLT) and 146 (61.3%) had living donor liver transplantation (LDLT). The median preoperative Model for End-stage Liver Disease score was 25 (range, 6–40), with 37 for DDLT and 17.8 for LDLT. The median age was 53 years (range, 27–69 years), with 162 males (68.1%) and 76 females (31.9%). The relapse rate in DDLT patients was significantly higher at 44.6% compared to 21.9% in LDLT patients (P<0.001). There was no significant difference in relapse rates based on the relationship between donor and recipient in LDLT, and posttransplant alcohol relapse did not affect patient survival (P=0.177). Interestingly, in patients with alcohol relapse, adherence to immunosuppressive medication significantly influenced survival rates (P=0.011). The higher the adherence to immunosuppressive medication, the higher the survival rate compared to those with poor medication adherence (P=0.021).
Conclusions
This study shows that although the rate of alcohol relapse after liver transplantation is high in patients with alcoholic liver disease, it does not adversely affect the survival rate in patients who take immunosuppressant well. Therefore, it is necessary not only to develop an educational program to reduce alcohol relapse but also to provide ongoing education on adherence to immunosuppressive medication.