Evaluation of efficacy of liver transplantation in alcoholic cirrhosis using matched and simulated controls: 5-year survival
Abstract
Background/aims Alcoholic cirrhosis is the most common cause of liver transplantation in US males. The limited number of donor livers calls for "prioritisation", favouring those patients who will benefit most. The aim was to assess the efficacy of liver transplantation in patients with alcoholic cirrhosis.Methods We compared the survival of 169 transplanted patients with two conservatively treated control groups, one of 169 patients matched for prognostic factors (age, cirrhosis severity, bleeding history) and one of 169 simulated patients.Results The probability of survival to 5 years in the transplanted group was 66% (95% confidence interval 58-74%) vs. 52% (44-60; p = 0.03) in the matched group and 54% (51-57; p = 0.01) in the simulated controls. Transplantation was associated with survival (relative risk = 1.51; p = 0.02), independently of risk score (risk = 2.07; p<0.001), indication, period of inclusion, centre experience, and alcohol abstinence. Patients with severe disease (Pugh C11-15) benefited most in terms of 5-year survival: 58% (44-72) vs. 31% (17-45; p = 0.008) in the matched and 35% (30-40; p<0.001) in the simulated control groups. For patients at lower risk there was no significant difference.Conclusions Liver transplantation increases the 5-year survival of patients with severe alcoholic cirrhosis. In patients at lower risk, efficacy of transplantation should be confirmed by longer follow-up or by randomised trial.
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Liver transplant has been shown to improve survival.
“While liver transplant has been shown to improve survival [83]”
From Liver cirrhosis mortality in 187 countries between 1980 and 2010: a systematic analysis (2014) · cites this paper as [83]
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Liver cirrhosis mortality in 187 countries between 1980 and 2010: a systematic analysis
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- Authors
- Poynard, T., Naveau, S., Doffoel, M., Boudjema, K., Vanlemmens, C., Mantion, G., Messner, M., Launois, B., Samuel, D., Cherqui, D., Pageaux, G., Bernard, P. H., Calmus, Y., Zarski, J. P., & Miguet, J. P.
- Affiliations
- Pitié-Salpêtrière Hospital (FR)
- Corresponding author
- Poynard, Thierry
- ORCID
- Venue
- Journal of Hepatology
- Publisher
- Elsevier BV
- Published
- 1999-06
- Volume
- 30
- Issue
- 6
- Pages
- 1130-1137
- ISSN
- 0168-8278 (ISSN-L)
- OpenAlex
- W2080831300
- Cited by
- 110
- References
- 15
- Citations by year
- 2025: 1 · 2023: 2 · 2022: 2 · 2021: 2 · 2020: 1 · 2019: 1 · 2018: 4 · 2017: 2 · 2016: 3 · 2015: 6 · 2014: 3 · 2013: 6 · 2012: 2
- FWCI
- 1.93
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Hepatology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Centre National de la Recherche Scientifique
- Topics
- Health Sciences › Medicine › Hepatology › Liver Disease and Transplantation
- Health Sciences › Medicine › Surgery › Organ Transplantation Techniques and Outcomes
- Health Sciences › Medicine › Pathology and Forensic Medicine › Alcohol Consumption and Health Effects
- Keywords
- liver transplantation, alcoholic cirrhosis, five-year survival, transplant efficacy, conservative treatment, matched controls, standardized patients, Pugh score, risk stratification, alcohol abstinence
- MeSH terms
- Humans, Liver Cirrhosis, Alcoholic, Models, Statistical, Survival Rate, Case-Control Studies, Liver Transplantation, Treatment Outcome
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