Survey of Liver Transplantation Practices for Severe Acute Alcoholic Hepatitis

Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society
Saroja BangaruArjmand R Mufti

Abstract

Liver transplantation (LT) has a demonstrated survival benefit in select patients with severe acute alcoholic hepatitis (SAH) who do not respond to steroids, but prior studies suggest low adoption among US LT centers. Our study explored current perceptions and practice patterns of LT for SAH in the United States. We administered a Web-based survey to medical directors of US LT centers between May and October of 2017 to characterize practice patterns and perceptions of LT for SAH. We obtained responses from 45 (41.3%) of 109 surveyed centers, representing all 11 (100%) United Network for Organ Sharing regions. Half (n = 23; 51.1%) reported performing at least 1 LT for SAH, although most (n = 19; 82.6%) of those had performed ≤5 LTs for that indication. Centers expressed near consensus for selection criteria, requiring strong social support (100%), no prior presentations with SAH (91.3%), absence of a severe coexisting psychiatric disorder (91.3%), and official psychosocial evaluation (87.0%). Reported posttransplant survival of SAH patients was excellent, with 17 (73.9%) centers reporting 1-year posttransplant survival exceeding 90%. Among centers that had not performed LT for SAH, the most commonly cited reason was perceived hi...Continue Reading

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Citations

Sep 16, 2018·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Moana Gelu-Simeon, Philippe Mathurin
May 8, 2019·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Jeanne-Marie GiardNorah A Terrault
Oct 28, 2019·The American Journal of Bioethics : AJOB·Kelsey N BerryKeren Ladin
Jul 18, 2019·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·David W CrabbMichael R Lucey
Jun 13, 2020·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·Thomas G CotterMichael Charlton
Nov 23, 2019·Journal of Translational Medicine·Vahid HosseiniReza Rahbarghazi
Nov 20, 2019·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Sumeet K AsraniGoran Klintmalm
Jun 27, 2019·Clinical Liver Disease·Gene Y Im
Jun 1, 2021·Journal of Hepatology·Philippe Mathurin
Jul 27, 2021·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·George CholankerilFasiha Kanwal
Dec 5, 2021·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Alyson KaplanRobert S Brown

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