Liver transplantation (LT) for alcohol-associated liver disease (ALD) demands Alcohol abstinence before LT. However, some patients might relapse, leading to LT in patients with non-abstinence during the pretransplant period. No data exist regarding the Long-term survival outcomes of these patients. 

A study determined if alcohol consumption on the day of the LT influences the long-term survival after LT. A retrospective case-control study was conducted among French LT centers. LT recipients with positive blood and/or urine alcohol levels on the day of LT were considered as cases. 2 controls were matched for every case resembling patients transplanted for ALD during the same trimester. 

Patients were categorized into 3 groups as per their alcohol consumption as 

• abstainers, 
• occasional or transitory excessive consumers, 
• patients with sustained excessive consumption (daily consumption >20-30 g/day). 

The following observations were made-

• 3052 LTs for ALD were recorded.  
• 42 cases paired with 84 controls were included. 
• Median blood alcohol and urine alcohol levels were found to be 0.4 g/L and 0.2 g/L, respectively. 
• 12.9 years was the Median follow-up period until death or censoring. 
• Similarities in Long-term survival were observed between the groups. 
• Case group showed greater relapse to any alcohol consumption rate (59.5%) than the control group.
• Sustained excessive consumption was not found to be markedly different between the groups (33.3% and 29.8% in case and control groups respectively). 
• The case group demonstrated more frequent rates of recurrent cirrhosis and cirrhosis-related deaths.

Thus, non-abstinence during the immediate pretransplant period does not cause impaired long-term survival in patients despite greater relapse and recurrent cirrhosis rates.

Source- Ursic-Bedoya J, Dumortier J, Altwegg R, Belkacemi M, Vanlemmens C, Dharancy S et al. Alcohol Consumption the Day of Liver Transplantation for Alcohol-Associated Liver Disease Does Not Affect Long-Term Survival: A Case-Control Study, Hepatology, 2021;27(1):34-42.