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Liver transplantation in alcoholic liver disease

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

There is controversy concerning the priority to be given to patients requiring a liver transplant due to alcoholic liver disease (ALD).

The results of liver transplantation for ALD are as good as the results for non-alcoholics:

  • 1 year survival of 85%
  • 5 year survival of 70%
  • similar outcomes up to 10 years

Return to drinking post-transplant is:

  • a quarter at one year
  • a third at three years

Because return to drinking is thought to be a bad prognostic factor most centres insist that potential recipients abstain from alcohol (NICE suggest abstinence for at least 3 months) before they are considered for a liver transplant.

Referral for consideration of transplantation

NICE suggest to refer patients with decompensated liver disease to be considered for assessment for liver transplantation if they:

  • still have decompensated liver disease after best management and 3 months' abstinence from alcohol and
  • are otherwise suitable for transplantation

For the nationally agreed guidelines for liver transplant assessment in the context of alcohol-related liver disease, see www.uktransplant.org.uk/ukt/about_transplants/organ_allocation/pdf/liver_advisory_group_alcohol_guidelines-november_2005.pdf

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