The Liver Unit, Freeman Hospital, Newcastle upon Tyne, UK.
The Liver Unit, St James's University Hospital, Leeds, UK.
Lancet Gastroenterol Hepatol. 2021 Nov;6(11):947-955. doi: 10.1016/S2468-1253(21)00195-3.
Liver disease, of which liver cirrhosis is the most advanced stage, constitutes the fourth most common cause of life-years lost in men and women younger than 75 years in England, where mortality rates from liver disease have increased by 25% in the past decade. Alcohol consumption is the most common modifiable risk factor for disease progression in these individuals, but within the UK, there is substantial variation in the distribution, prevalence, and outcome of alcohol-related liver disease, and no equity of access to tertiary transplantation services. These revised recommendations were agreed by an expert panel convened by the UK Liver Advisory Group, with the purpose of providing consensus on referral for transplant assessment in patients with alcohol-related disease, and clarifying the terminology and definitions of alcohol use in liver injury. By standardising clinical management in these patients, it is hoped that there will be an improvement in the quality of care and better access to liver transplant assessment for patients with alcohol-related liver disease in the UK.
在英格兰,75 岁以下人群中,因肝病而导致的寿命损失年数居第四位,其中肝硬化是肝病的最严重阶段。在过去十年中,英格兰的肝病死亡率上升了 25%。在这些人群中,酒精是导致疾病进展的最常见可改变风险因素,但在英国,酒精性肝病的分布、流行和结局存在很大差异,且获得三级移植服务的机会也不平等。这些修订建议是由英国肝脏咨询组召集的专家小组达成的,目的是就酒精相关疾病患者的移植评估转诊达成共识,并澄清肝损伤中酒精使用的术语和定义。通过对这些患者的临床管理进行标准化,有望改善护理质量,并为英国的酒精性肝病患者提供更好的肝移植评估机会。