Remission of severe alcoholic polyneuropathy after liver transplantation

Alcoholic polyneuropathy presents with variable severity. Only few very severely disabled patients showed good clinical and electrophysiological improvement after cessation of alcohol abuse. We report a 55 year old patient with polyneuropathy who underwent orthotopic liver transplantation for decompensated alcoholic cirrhosis. After an initial postoperative exacerbation of her neurological disorder the patient developed an impressive remission of her clinical condition during the 4 year post transplantation follow up period. Nine months after surgery the initially wheel chair bound patient regained the ability to walk on her own. The previously severely impaired sensory modalities returned to nearly normal function. Electrophysiological findings also improved. The right tibial nerve conduction velocity increased from 16.8 to 26.7 m/s between the 27th and 37th post transplantation month. We postulate that liver transplantation facilitated the remission of this patient's alcohol-induced polyneuropathy. This observation suggests that alcoholic polyneuropathy, even when severe, should not be considered a contraindication for liver transplantation.