Berlakovich Gabriela A
Department of Transplant Surgery, University of Vienna, Austria.
Ann Transplant. 2005;10(1):38-43.
Alcoholic liver disease is the leading cause of end-stage liver disease and the second most common indication for liver transplantation (OLT) in the United States and Europe, with the number of patients receiving transplants each year representing about 5% of the estimated deaths from alcoholic cirrhosis. Long-term patient survival rates compare favorable with those for other chronic liver diseases. Nevertheless, there remains a certain ambivalence about the role of OLT in patients suffering from alcoholic cirrhosis, based partly on concerns regarding alcohol relapse and functional outcome post-transplant in an era of donor organ shortage and priority setting. This review article focuses especially on compliance and social rehabilitation of patients who have undergone OLT for alcoholic cirrhosis. Furthermore, pre-transplant evaluation and selection of potential candidates are discussed and guidelines are given to clarify the role of OLT in the management of patients suffering from alcoholic cirrhosis. It appears very important to mention that alcoholism is not a fault but represents a disease, and provided that the underlying disease can be treated, consequent disease (end-stage liver disease) should be treated, too.
酒精性肝病是终末期肝病的主要病因，在美国和欧洲是肝移植（OLT）的第二大常见适应症，每年接受移植的患者数量约占酒精性肝硬化估计死亡人数的5%。长期患者生存率与其他慢性肝病相比情况良好。然而，对于OLT在酒精性肝硬化患者中的作用仍存在一定的矛盾态度，部分原因是在供体器官短缺和确定优先次序的时代，人们担心移植后酒精复饮和功能结局。这篇综述文章特别关注接受酒精性肝硬化OLT治疗的患者的依从性和社会康复情况。此外，还讨论了潜在候选者的移植前评估和选择，并给出了指导方针，以阐明OLT在酒精性肝硬化患者管理中的作用。需要提及的是，酗酒不是一种过错，而是一种疾病，只要基础疾病能够得到治疗，随之而来的疾病（终末期肝病）也应该得到治疗，这一点显得非常重要。
