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      저자 : ( Jeffrey Samuel Co ) (검색결과 1 건)
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      • The Evolution of Living Donor Liver Transplantation for Alcoholic Liver Cirrhosis in a High Volume Center: The Eastern Perspective

        ( Jeffrey Samuel Co ),( Chih-chi ),( Wang ),( Chih-che Lin ),( Chee-chien Yong ),( Chao Long Chen ) 대한간학회 2020 춘·추계 학술대회 (KASL) Vol.2020 No.1

        Aims: Alcoholic liver disease (ALD) has been a growing indication for living donor liver transplantation (LDLT) in Asia but certain medical, ethical and psycho-social issues question its appropriateness. Reports on long-term outcomes of LDLT for ALD are also scarce and so our aim was to report our center’s experience for the past 15 years and how LDLT has evolved to be the treatment of choice for end-stage liver disease secondary to ALD in a high volume center. Methods: A total of 1,384 consecutive LDLT was performed from January 2003 to August 2016 at Kaohsiung Chang Gung Memorial Hospital, and 87 patients had a pre-operative diagnosis of alcoholic liver disease (ALD) with or without hepatocellular carcinoma (HCC). This group was systematically matched with non-ALD (NALD) patients in a ratio of 1:2 using equiprobability method. Overall patient survival was compared using Kaplan-Meier analysis, and incidences of post-transplant De novo malignancy and alcohol relapse were described. Results: Patient demographics were comparable, as well as preoperative and intra-operative data. Of the 87 patients in the ALD group, 26 (30%) had concomitant HCC. Median follow- up for this study was 50 months. Overall patient survival at 1, 3 and 5 years for ALD were 98%, 97% and 92% respectively, while the NALD group had similar survival rates (P =0.282). The rate for De novo malignancy was 6% while that for recidivism was 7% despite only 76% of the patients meeting the 6 months abstinence rule. Conclusions: Results from our center show that LDLT for ALD has comparable short and longterm outcomes when compared to NALD, and the close relationship between donor and recipient seems to positively affect alcohol relapse rate and patient compliance to medication.

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