Liver transplantation for alcoholic hepatitis: A systematic review with meta-analysis.

Détails

Ressource 1Télécharger: 29324766_BIB_1B8603330B21.pdf (2485.84 [Ko])
Etat: Public
Version: Final published version
Licence: CC BY 4.0
ID Serval
serval:BIB_1B8603330B21
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Liver transplantation for alcoholic hepatitis: A systematic review with meta-analysis.
Périodique
PloS one
Auteur(s)
Marot A., Dubois M., Trépo E., Moreno C., Deltenre P.
ISSN
1932-6203 (Electronic)
ISSN-L
1932-6203
Statut éditorial
Publié
Date de publication
2018
Peer-reviewed
Oui
Volume
13
Numéro
1
Pages
e0190823
Langue
anglais
Notes
Publication types: Journal Article ; Meta-Analysis ; Review
Publication Status: epublish
Résumé
The rate of alcohol relapse among patients who underwent liver transplantation for alcoholic hepatitis (AH) is not precisely known.
Synthesize the available evidence on liver transplantation for AH to assess alcohol relapse and 6-month survival.
Meta-analysis of trials evaluating liver transplantation for AH, either clinically severe or diagnosed on the explant.
Eleven studies were included. The pooled estimate rate for alcohol relapse was 0.22 (95% CI = 0.12-0.36) in overall analysis with high heterogeneity between studies (I2 = 76%), 0.20 (95% CI = 0.07-0.43) in the subgroup analysis including patients with clinically severe AH (I2 = 84%), 0.14 (95% CI = 0.08-0.23) among patients with clinically severe AH in sensitivity analysis excluding the discrepant studies that did not use stringent selection criteria for liver transplantation (I2 = 0%), and 0.15 (95% CI = 0.07-0.27) for recurrent harmful alcohol consumption among patients with clinically severe AH (I2 = 3%). The risk of alcohol relapse was not different between AH transplanted patients and patients with alcoholic cirrhosis who underwent elective liver transplantation in sensitivity analysis excluding the discrepant studies (OR = 1.68, 95%CI = 0.79-3.58, p = 0.2, I2 = 16%). The pooled estimate rate for 6-month survival was 0.85 (95% CI = 0.77-0.91, I2 = 49%), and 0.80 among patients transplanted for clinically severe AH (95% CI = 0.69-0.88, I2 = 30%). AH transplanted patients had similar 6-month survival to patients with alcoholic cirrhosis who underwent elective liver transplantation (OR = 2.00, 95% CI = 0.95-4.23, p = 0.07, I2 = 0%).
Using stringent selection criteria, 14% of patients with clinically severe AH have alcohol relapse after liver transplantation. The percentage of alcohol relapse of AH transplanted patients is similar than that of patients who underwent elective liver transplantation.

Mots-clé
Alcohol Abstinence, Alcoholism/complications, Elective Surgical Procedures, Hepatitis, Alcoholic/surgery, Humans, Liver Transplantation, Recurrence
Pubmed
Web of science
Open Access
Oui
Création de la notice
27/01/2018 10:03
Dernière modification de la notice
20/08/2019 12:52
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