Secondary Logo

Institutional members access full text with Ovid®

Share this article on:

Heavy Alcohol Use Among Deceased Donors Does Not Impact Recipient Outcomes After Liver Transplantation

Arora, Sumant S., MD1; Chahal, Khushdeep S., MD2; Axley, Page, MD3; Eckhoff, Devin E., MD4; Kuo, Yong-Fang, MD5; Satapathy, Sanjaya K., MD6; Wiesner, Russell, MD7; Singal, Ashwani K., MD, MS8

doi: 10.1097/TP.0000000000002230
Original Clinical Science—Liver

Background Data on liver transplant (LT) outcomes using deceased donors with heavy drinking (HD) (>2 drinks per day) are scanty.

Methods Using the United Network for Organ Sharing database (2002-2014), we examined outcomes after LT in adults comparing deceased HD donors with non-HD (ND) donors.

Results Of 56 182 first LTs performed in the United States for 10 common indications using deceased donors, 47 882 with available information on alcohol use were analyzed. Of these 47 882 LT recipients, 7298 (15%) were from HD donors, with similar proportion over time (2002-2014, Armitage trend test P = 0.75) and for recipient liver disease etiology (χ2 P = 0.42). Proportion of liver organ used for LT was lower for HD donors compared with ND donors (63% vs 78%; P < 0.001). Five-year outcomes on first LT comparing 7166 HD donors and 21 498 ND donors matched based on propensity score were similar for liver graft (73.7% vs 73.7%, log rank P = 0.98) and patient survival (77.6% vs 77.0%, P = 0.36). On Cox regression analysis, history of HD in deceased donors did not affect liver graft 1.02 (0.97-1.08) or patient survival 1.03 (0.97-1.09).

Conclusions Among LT recipients using select liver grafts, history of HD in deceased donors does not impact outcomes after LT.

Using the United Network for Organ Sharing database (2002-2014), the authors examine postliver transplantation outcomes in adults comparing deceased donors with heavy drinking (HD) with not heavy drinking donors and conclude that history of HD in deceased donors does not appear to impact graft or patient survival.

1 Department of Internal Medicine, University of Alabama at Birmingham-Montgomery Regional Campus, Birmingham, AL.

2 Department of Internal Medicine, University of Alabama at Birmingham-Huntsville Regional Campus, Birmingham, AL.

3 Department of Internal Medicine, University of Alabama at Birmingham, Birmingham, AL.

4 Department of Transplant Surgery, University of Alabama at Birmingham, Birmingham, AL.

5 Department of Biostatistics, University of Texas Medical Branch, Galveston, TX.

6 Division of Transplant Surgery, Department of Surgery, Methodist University Hospital Transplant Institute, University of Tennessee Health Sciences Center, Memphis, TN.

7 Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, NY.

8 Division of Gastroenterology and Hepatology, University of Alabama at Birmingham, Birmingham, AL.

Received 9 December 2017. Revision received 16 March 2018.

Accepted 18 March 2018.

This study was supported by a faculty development grant from the American College of Gastroenterology to Ashwani K. Singal.

All authors were involved in the final approval of the version of the article submitted and have agreed to be accountable for all aspects of the work.

The authors declare no conflicts of interest.

A.K.S., S.A., and K.S.C. conceptualized the study hypothesis, design, and methodology. S.A. and K.S.C. collected data for the study. A.K.S. and Y.-F.K. performed the statistical analysis. S.A., K.S.C., P.A., and A.K.S. drafted the article. A.K.S., Y.-F.K., S.S., D.E.E., and R.W. contributed to critical revision of the manuscript for important intellectual content and expert opinion. All authors approved the final draft submitted. A.S. is the author guarantor.

Correspondence: Ashwani K Singal, MD, MS, FACG, FAASLD, University of Alabama at Birmingham, Division of Gastroenterology and Hepatology, 808, 7th Ave South, BDB 351, Birmingham, AL 35294–0012, (ashwanisingal.com@gmail.com).

Supplemental digital content (SDC) is available for this article. Direct URL citations appear in the printed text, and links to the digital files are provided in the HTML text of this article on the journal’s Web site (www.transplantjournal.com).

Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.