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doi: 10.53388/ghr2024002
Published online: March 29, 2024
Citation: Asmare W, Eze I, Gordon D, Singh G, Ali Ali MJ. The effect of alcohol and eligibility for liver transplant: a critical review. Gastroenterol & Hepatol Res. 2024;6(1):2. doi: 10.53388/ghr2024002.
Alcohol-related liver disease (ALRD) has emerged as a significant global health concern, primarily attributed to the overconsumption of alcohol. While alcoholism has the potential to impact various organs, it is the liver that is especially vulnerable.
This review comprehensively examines the challenges encountered during the pre-transplant, intra-transplant, and post-transplant phases, a significant number of which are attributable to alcohol misuse. Historically, liver transplant (LT) programmes have excluded patients with alcohol-related liver disease (ARLD) due to mandatory abstinence requirements and apprehensions regarding potential graft shortages for other hepatic diseases. This review counters these concerns by highlighting the minimal usage of grafts for early liver transplantation. It strongly advocates for the incorporation of severe alcoholic hepatitis into the model for end-stage liver disease allocation, devoid of any stigmatization. The selection of ARLD individuals for LT necessitates the critical involvement of a multidisciplinary team, inclusive of addiction specialists.
Despite the complexities associated with LT for patients with ARLD, this review underscores its therapeutic advantages, particularly for those anticipated to experience severe adverse effects. This review accentuates the necessity of ensuring equitable access to medical interventions for all patients, irrespective of their lifestyle choices.
The examination of genetic and epigenetic variables that play a role in the onset and advancement of ALD. The identification of potential therapy strategies is also an important area of study. The formulation of intricate eligibility rules for LT in patients with a past of alcohol abuse needs essential interactions between medical practitioners and researchers. The use of new technologies such as genomics and epigenomics could boost the accuracy of ALD diagnostic and prognostic approaches. These targeted investigations could potentially lead to major improvements in the management and treatment results of ALD.
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