Section of Gastroenterology and Hepatology, Department of Medicine, H6/516 CSC, University of Wisconsin Hospitals and Clinics, 600 Highland Ave, Madison, WI 53792, USA.
J Hepatol. 2010 May;52(5):759-64. doi: 10.1016/j.jhep.2009.12.021. Epub 2010 Feb 18.
Although most patients with alcoholic liver disease experience positive outcomes following liver transplantation, data on the outcome after liver transplantation in patients with severe alcoholic hepatitis are limited. Furthermore, predicting which patients with severe alcoholic hepatitis will maintain sobriety after transplantation is especially difficult. We review the arguments in favour and against extending liver transplantation to selected patients with severe alcoholic hepatitis. In conclusion, we propose that liver transplantation should be a rescue option for occasional patients with severe alcoholic hepatitis who meet the following criteria: those with severe alcoholic hepatitis that has failed medical management, who fulfil all other standard criteria for transplantation, including a thorough psychosocial assessment, yet who are unlikely to survive a mandatory 6-month abstinence period.
尽管大多数酒精性肝病患者在接受肝移植后预后良好，但关于重症酒精性肝炎患者肝移植后结局的数据有限。此外，预测哪些重症酒精性肝炎患者在移植后能保持戒酒状态尤其困难。我们综述了支持和反对将肝移植扩展到特定重症酒精性肝炎患者的观点。总之，我们建议对于符合以下标准的偶发重症酒精性肝炎患者，肝移植应该是一种挽救性选择：经药物治疗无效的重症酒精性肝炎患者，符合所有其他移植标准，包括全面的社会心理评估，但在强制性 6 个月戒酒期内不太可能存活的患者。
