ArticleGastroenterology2019
Model to Calculate Harms and Benefits of Early vs Delayed Liver Transplantation for Patients With Alcohol-Associated Hepatitis.
Article in Gastroenterology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers.
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Who cites it
27 citing papers in PubMed.
- Cardiometabolic Risk Factors Impair Recompensation and Survival in Alcohol-Associated Liver Disease.Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2026Observational
- A global consensus on the critical care management of acute-on-chronic liver failure patients: the APASL ACLF Beijing Position Paper.Hepatology international · 2026Article
- Multifactor Risk Stratification for Post-Transplant Alcohol Relapse Using Abstinence, Psychosocial, and Socioeconomic Factors.Annals of gastroenterological surgery · 2026Article
- Spontaneous Recovery and Mortality in Patients With ALD Referred for Early Liver Transplantation.The American journal of gastroenterology · 2026Article
- Outcomes of Liver Transplantation Without Alcohol Abstinence in Alcohol-Associated Hepatitis With Original MELD Score ≥30.Annals of transplantation · 2026Observational
- Steatotic liver disease and liver transplantation: Candidate selection and post-transplant management.JHEP reports : innovation in hepatology · 2026Review
- Alcohol Relapse After Liver Transplantation: Advances in Risk Stratification, Biomarker Integration, and Post-Transplant Care.Gastro hep advances · 2026Review
- Balancing abstinence and harm reduction across the continuum of care for liver transplantation in alcohol-associated liver disease.Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society · 2025Review
- Alcohol Relapse After Liver Transplantation: Risk Factors, Outcomes, and a Comparison of Risk Stratification Models.Gastro hep advances · 2025Article
- Intestinal Microbiotas and Alcoholic Hepatitis: Pathogenesis and Therapeutic Value.International journal of molecular sciences · 2023Review
- Early Liver Transplantation for Severe Alcohol-Associated Hepatitis and a History of Prior Liver Decompensation.The American journal of gastroenterology · 2022Article
- Natural History of Alcohol-Associated Liver Disease: Understanding the Changing Landscape of Pathophysiology and Patient Care.Gastroenterology · 2022Review
- Advocacy for Equity in Transplantation Access for Alcohol-Associated Liver Disease: How Research Changed Medi-Cal Policy.Gastroenterology · 2022Article
- Liver regeneration as treatment target for severe alcoholic hepatitis.World journal of gastroenterology · 2022Review
- Artificial intelligence to identify harmful alcohol use after early liver transplant for alcohol-associated hepatitis.American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · 2022Article
- [Progress in the clinical treatment of alcoholic hepatitis].Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese journal of hepatology · 2022Article
- Establishing a blueprint for successful liver transplantation for alcohol-related cirrhosis: the importance of a multidisciplinary team.Hepatobiliary surgery and nutrition · 2022Article
- Impact of COVID-19 Pandemic on Liver Transplantation and Alcohol-Associated Liver Disease in the USA.Hepatology (Baltimore, Md.) · 2021Article
- Approaching Alcohol Use Disorder After Liver Transplantation for Acute Alcoholic Hepatitis.Clinics in liver disease · 2021Review
- Outcome of patients with severe alcoholic hepatitis after Model for End-Stage Liver Disease-based allocation system implementation in Korea.Korean journal of transplantation · 2021Article
Corrections and comments
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Authors and funding
17 authors.
Funding
Abstract
BACKGROUND &
aimsEarly liver transplantation (without requiring a minimum period of sobriety) for severe alcohol-associated hepatitis (AH) is controversial: many centers delay eligibility until a specific period of sobriety (such as 6 months) has been achieved. To inform ongoing debate and policy, we modeled long-term outcomes of early vs delayed liver transplantation for patients with AH.
methodsWe developed a mathematical model to simulate early vs delayed liver transplantation for patients with severe AH and different amounts of alcohol use after transplantation: abstinence, slip (alcohol use followed by sobriety), or sustained use. Mortality of patients before transplantation was determined by joint-effect model (based on Model for End-Stage Liver Disease [MELD] and Lille scores). We estimated life expectancies of patients receiving early vs delayed transplantation (6-month wait before placement on the waitlist) and life years lost attributable to alcohol use after receiving the liver transplant.
resultsPatients offered early liver transplantation were estimated to have an average life expectancy of 6.55 life years, compared with an average life expectancy of 1.46 life years for patients offered delayed liver transplantation (4.49-fold increase). The net increase in life expectancy from offering early transplantation was highest for patients with Lille scores of 0.50-0.82 and MELD scores of 32 or more. Patients who were offered early transplantation and had no alcohol use afterward were predicted to survive 10.85 years compared with 3.62 years for patients with sustained alcohol use after transplantation (7.23 life years lost). Compared with delayed transplantation, early liver transplantation increased survival times in all simulated scenarios and combinations of Lille and MELD scores.
conclusionsIn a modeling study of assumed carefully selected patients with AH, early vs delayed liver transplantation (6 months of abstinence from alcohol before transplantation) increased survival times of patients, regardless of estimated risk of sustained alcohol use after transplantation. These findings support early liver transplantation for patients with severe AH. The net increase in life expectancy was maintained in all simulated extreme scenarios but should be confirmed in prospective studies. Sustained alcohol use after transplantation significantly reduced but did not eliminate the benefits of early transplantation. Strategies are needed to prevent and treat posttransplantation use of alcohol.
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