Transplantation for alcoholic liver disease: a perspective from Europe

It is now accepted that patients who receive a liver transplant for alcohol-related liver disease have a rate of survival similar to those who receive grafts for other indications. Abstinence from alcohol before liver transplantation is important in ensuring that the liver will not recover, but the period of abstinence required before transplantation is undertaken is uncertain. Prognostic models for assessing patients with alcoholic liver disease have been developed but correlate poorly with each other. A return to alcohol consumption after transplantation is not uncommon, although graft failure or damage is uncommon. However, alcohol-related liver disease is becoming an increasing indication for liver transplantation. As the number of potential candidates exceeds the supply of donors, some form of rationing will be required. The general public places a lower priority on transplantation for alcoholic liver disease than for other indications, and this will need to be considered by those who allocate the donor livers.