Liver transplantation for alcoholic hepatitis: A systematic review with meta-analysis.

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Version: Final published version
License: CC BY 4.0
Serval ID
serval:BIB_1B8603330B21
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Liver transplantation for alcoholic hepatitis: A systematic review with meta-analysis.
Journal
PloS one
Author(s)
Marot A., Dubois M., Trépo E., Moreno C., Deltenre P.
ISSN
1932-6203 (Electronic)
ISSN-L
1932-6203
Publication state
Published
Issued date
2018
Peer-reviewed
Oui
Volume
13
Number
1
Pages
e0190823
Language
english
Notes
Publication types: Journal Article ; Meta-Analysis ; Review
Publication Status: epublish
Abstract
The rate of alcohol relapse among patients who underwent liver transplantation for alcoholic hepatitis (AH) is not precisely known.
Synthesize the available evidence on liver transplantation for AH to assess alcohol relapse and 6-month survival.
Meta-analysis of trials evaluating liver transplantation for AH, either clinically severe or diagnosed on the explant.
Eleven studies were included. The pooled estimate rate for alcohol relapse was 0.22 (95% CI = 0.12-0.36) in overall analysis with high heterogeneity between studies (I2 = 76%), 0.20 (95% CI = 0.07-0.43) in the subgroup analysis including patients with clinically severe AH (I2 = 84%), 0.14 (95% CI = 0.08-0.23) among patients with clinically severe AH in sensitivity analysis excluding the discrepant studies that did not use stringent selection criteria for liver transplantation (I2 = 0%), and 0.15 (95% CI = 0.07-0.27) for recurrent harmful alcohol consumption among patients with clinically severe AH (I2 = 3%). The risk of alcohol relapse was not different between AH transplanted patients and patients with alcoholic cirrhosis who underwent elective liver transplantation in sensitivity analysis excluding the discrepant studies (OR = 1.68, 95%CI = 0.79-3.58, p = 0.2, I2 = 16%). The pooled estimate rate for 6-month survival was 0.85 (95% CI = 0.77-0.91, I2 = 49%), and 0.80 among patients transplanted for clinically severe AH (95% CI = 0.69-0.88, I2 = 30%). AH transplanted patients had similar 6-month survival to patients with alcoholic cirrhosis who underwent elective liver transplantation (OR = 2.00, 95% CI = 0.95-4.23, p = 0.07, I2 = 0%).
Using stringent selection criteria, 14% of patients with clinically severe AH have alcohol relapse after liver transplantation. The percentage of alcohol relapse of AH transplanted patients is similar than that of patients who underwent elective liver transplantation.

Keywords
Alcohol Abstinence, Alcoholism/complications, Elective Surgical Procedures, Hepatitis, Alcoholic/surgery, Humans, Liver Transplantation, Recurrence
Pubmed
Web of science
Open Access
Yes
Create date
27/01/2018 10:03
Last modification date
20/08/2019 12:52
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