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Alcohol-linked disease overtakes hepatitis C as top reason for liver transplant

Alcohol-associated liver disease edges out hepatitis C as the No. 1 reason for liver transplants in the U.S.


Rachel Bluth
January 27, 2019 2:00AM (UTC)
This article originally appeared on Kaiser Health News.

An estimated 17,000 Americans are on the waiting list for a liver transplant, and there’s a strong chance that many of them have alcohol-associated liver disease. ALD now edges out hepatitis C as the No. 1 reason for liver transplants in the United States, according to research published Tuesday in JAMA Internal Medicine.

One reason for the shift, researchers said, is that hepatitis C, which used to be the leading cause of liver transplants, has become easier to treat with drugs.

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Another could be an increasing openness within the transplant community to a candidate’s history of alcohol and addiction and when a candidate combating these issues can qualify for a liver.

For years, conventional wisdom suggested that people with a heavy drinking past who did not have a period of sobriety under their belts would not be good candidates to receive a new liver. But, of almost 33,000 liver transplant patients since 2002 who were studied, researchers from the University of California-San Francisco found 36.7 percent of them had ALD in 2016, up from 24.2 percent in 2002.

“Across the country, and we show in a prior study, people are changing their minds,” said Dr. Brian P. Lee, the study’s lead author and a UCSF gastroenterology and hepatology fellow. “More and more providers are willing to transplant patients with ALD.”

The debate, roiling for decades, culminated in 1997 when a group of doctors and medical societies and the U.S. surgeon general published a paper that recommended patients with alcoholic liver disease be sober at least six months before they could be considered for transplant.

This “six-month rule” became the gold standard. The idea was that a patient who could stay sober for that long had a lower chance of returning to harmful drinking behavior. There was also concern that the public would stop donating organs if they thought livers would be going to people with alcohol addictions.

“Neither of those attitudes are based on any facts or data,” said Dr. Robert Brown, director of the Center for Liver Disease and Transplantation at Weill Cornell and New York Presbyterian.

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Rachel Bluth

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All Salon Hepatitis C Kaiser Health News Liver Disease Liver Transplant Science & Health




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