Evidence map›Paper›PMID 35853462›Full record

ArticleThe American journal of gastroenterology2022

Early Liver Transplantation for Severe Alcohol-Associated Hepatitis and a History of Prior Liver Decompensation.

Ethan M Weinberg, Matthew Dukewich, Neha Jakhete, Elizabeth Stonesifer, Gene Y Im, Michael R Lucey, Kirti Shetty, John P Rice, David W Victor, Mark R Ghobrial and 10 more

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in The American journal of gastroenterology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.

0numbers the graph read from it
0cells of the map it votes in
12citing papers in PubMed
3.7field-weighted citation impact, top 6% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

12 citing papers in PubMed, 25 citations in OpenAlex.

  1. Observational
  2. Early liver transplantation in alcohol-associated liver disease-Evolution of practice, patient selection, management, and outcomes.Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society · 2026
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

20 authors at 8 institutions in 1 country.

Ethan M WeinbergDivision of Gastroenterology and Hepatology, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Matthew DukewichDepartment of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Neha JakheteDivision of Gastroenterology and Hepatology, University of Maryland School of Medicine, Baltimore, Maryland, USA.
Elizabeth StonesiferDivision of Gastroenterology and Hepatology, University of Maryland School of Medicine, Baltimore, Maryland, USA.
Gene Y ImRecanati/Miller Transplantation Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Michael R LuceyDivision of Gastroenterology and Hepatology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA.
Kirti ShettyDivision of Gastroenterology and Hepatology, University of Maryland School of Medicine, Baltimore, Maryland, USA.
John P RiceDivision of Gastroenterology and Hepatology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA.
David W VictorSherrie and Alan Conover Center for Liver Disease and Transplantation, Houston Methodist Hospital, Houston Texas, USA.
Mark R GhobrialSherrie and Alan Conover Center for Liver Disease and Transplantation, Houston Methodist Hospital, Houston Texas, USA.
Akshay ShettySherrie and Alan Conover Center for Liver Disease and Transplantation, Houston Methodist Hospital, Houston Texas, USA.
Stephanie M RutledgeDivision of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Sander S FlormanRecanati/Miller Transplantation Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Christine HsuDivision of Gastroenterology, Georgetown University School of Medicine, Washington, District of Columbia, USA.
Mohamed ShoreibahDivision of Gastroenterology and Hepatology, University of Alabama at Birmingham, Birmingham, Alabama, USA.
Mahmoud AryanDepartment of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA.
Babak J OrandiDivision of Transplantation, University of Alabama at Birmingham, Birmingham, Alabama, USA.
Hyosun HanDivision of Gastroenterology and Liver Diseases, University of Southern California, Los Angeles, California, USA.
Norah TerraultDivision of Gastroenterology and Liver Diseases, University of Southern California, Los Angeles, California, USA.
Brian P LeeDivision of Gastroenterology and Liver Diseases, University of Southern California, Los Angeles, California, USA.ORCID 0000-0003-2108-1287
Icahn School of Medicine at Mount Sinai · USMethodist Hospital · USUniversity of Alabama at Birmingham · USUniversity of Maryland, Baltimore · USUniversity of Southern California · USUniversity of Pennsylvania · USUniversity of Wisconsin–Madison · USGeorgetown University · US

Funding

Estimating the Contribution of Alcohol and Metabolic Risk to Liver Disease Progression to Inform Personalized InterventionsK23AA029752 · NIAAA · UNIVERSITY OF SOUTHERN CALIFORNIA · PI LEE, BRIAN PEI LIM · 2022 to 2025
$772k
Molecular Mechanisms of Stellate Cell Activation in Liver FibrosisI01BX001991 · VA · VA GREATER LOS ANGELES HEALTHCARE SYSTEM · PI HIDEKAZU TSUKAMOTO · 2014 to 2026
–
NIAAA NIH HHS K23 AA029752
6 · The paper itself

Abstract

introductionIn the published studies of early liver transplantation (LT) for alcohol-associated hepatitis (AH), patients with a prior liver decompensation are excluded. The appropriateness of this criteria is unknown.

methodsAmong 6 American Consortium of Early Liver Transplantation for Alcohol-Associated Hepatitis sites, we included consecutive early LT for clinically diagnosed AH between 2007 and 2020. Patients were stratified as first vs prior history of liver decompensation, with the latter defined as a diagnosis of ascites, hepatic encephalopathy, variceal bleeding, or jaundice, and evidence of alcohol use after this event. Adjusted Cox regression assessed the association of first (vs prior) decompensation with post-LT mortality and harmful (i.e., any binge and/or frequent) alcohol use.

resultsA total of 241 LT recipients (210 first vs 31 prior decompensation) were included: median age 43 vs 38 years ( P = 0.23), Model for End-Stage Liver Disease Sodium score of 39 vs 39 ( P = 0.98), and follow-up after LT 2.3 vs 1.7 years ( P = 0.08). Unadjusted 1- and 3-year survival among first vs prior decompensation was 93% (95% confidence interval [CI] 89%-96%) vs 86% (95% CI 66%-94%) and 85% (95% CI 79%-90%) vs 78% (95% CI 57%-89%). Prior (vs first) decompensation was associated with higher adjusted post-LT mortality (adjusted hazard ratio 2.72, 95% CI 1.61-4.59) and harmful alcohol use (adjusted hazard ratio 1.77, 95% CI 1.07-2.94). DISCUSSION: Prior liver decompensation was associated with higher risk of post-LT mortality and harmful alcohol use. These results are a preliminary safety signal and validate first decompensation as a criterion for consideration in early LT for AH patients. However, the high 3-year survival suggests a survival benefit for early LT and the need for larger studies to refine this criterion. These results suggest that prior liver decompensation is a risk factor, but not an absolute contraindication to early LT.

Indexed as

End Stage Liver DiseaseEsophageal and Gastric VaricesHepatitis, AlcoholicLiver TransplantationAdultGastrointestinal HemorrhageHumansRetrospective StudiesSeverity of Illness Index

Identifiers

PMID35853462
PMCPMC10361649
OpenAlexW4286242741

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.