Immediate Listing for Liver Transplantation for Alcoholic Cirrhosis: Curbing Our Enthusiasm
Authors: Sandeep Mukherjee, Michael F. Sorrell
Journal: Annals of Internal Medicine (2009)

Editorials3 February 2009Immediate Listing for Liver Transplantation for Alcoholic Cirrhosis: Curbing Our EnthusiasmSandeep Mukherjee, MD, MPH and Michael F. Sorrell, MDSandeep Mukherjee, MD, MPHFrom the University of Nebraska Medical Center, Omaha, NE 68198-3285.Search for more papers by this author and Michael F. Sorrell, MDFrom the University of Nebraska Medical Center, Omaha, NE 68198-3285.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-150-3-200902030-00012 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Liver transplantation has become the standard of care for end-stage liver disease, with 5-year survival rates approaching 70% to 80%. In the United States, allocation and timing of liver transplantation were first based on both waiting time and the Child–Pugh system. The Child–Pugh system characterizes disease severity by a scoring system involving laboratory and clinical features, as well as the physician's subjective assessment of the magnitude of ascites and encephalopathy, which are important components of the final score. In 2000, the Institute of Medicine recommended that disease severity, not time spent on the waiting list, should determine organ allocation in ...References1. Kamath PS, Kim WR; Advanced Liver Disease Study Group. The model for end-stage liver disease (MELD). Hepatology. 2007;45:797-805. [PMID: 17326206] CrossrefMedlineGoogle Scholar2. Jacob M, Copley LP, Lewsey JD, Gimson A, Toogood GJ, Rela M; UK and Ireland Liver Transplant Audit. Pretransplant MELD score and post liver transplantation survival in the UK and Ireland. Liver Transpl. 2004;10:903-7. [PMID: 15237375] CrossrefMedlineGoogle Scholar3. Ravaioli M, Grazi GL, Ballardini G, Cavrini G, Ercolani G, Cescon M, et al. Liver transplantation with the Meld system: a prospective study from a single European center. Am J Transplant. 2006;6:1572-7. [PMID: 16827857] CrossrefMedlineGoogle Scholar4. Fink MA, Angus PW, Gow PJ, Berry SR, Wang BZ, Muralidharan V, et al. Liver transplant recipient selection: MELD vs. clinical judgment. Liver Transpl. 2005;11:621-6. [PMID: 15915491] CrossrefMedlineGoogle Scholar5. Veldt BJ, Lainé F, Guillygomarc'h A, Lauvin L, Boudjema K, Messner M, et al. Indication of liver transplantation in severe alcoholic liver cirrhosis: quantitative evaluation and optimal timing. J Hepatol. 2002;36:93-8. [PMID: 11804670] CrossrefMedlineGoogle Scholar6. Lim JK, Keeffe EB. Liver transplantation for alcoholic liver disease: current concepts and length of sobriety. Liver Transpl. 2004;10:S31-8. [PMID: 15382288] CrossrefMedlineGoogle Scholar7. Watt KD, McCashland TM. Transplantation in the alcoholic patient. Semin Liver Dis. 2004;24:249-55. [PMID: 15349803] CrossrefMedlineGoogle Scholar8. Vanlemmens C, Di Martino V, Milan C, Messner M, Minello A, Duvoux C, et al; TRANSCIAL Study Group. Immediate listing for liver transplantation versus standard care for Child–Pugh stage B alcoholic cirrhosis. A randomized trial. Ann Intern Med. 2009;150:153-61. LinkGoogle Scholar9. Ahmad J, Bryce CL, Cacciarelli T, Roberts MS. Differences in access to liver transplantation: disease severity, waiting time, and transplantation center volume. Ann Intern Med. 2007;146:707-13. [PMID: 17502631] LinkGoogle Scholar10. Merion RM, Schaubel DE, Dykstra DM, Freeman RB, Port FK, Wolfe RA. The survival benefit of liver transplantation. Am J Transplant. 2005;5:307-13. [PMID: 15643990] CrossrefMedlineGoogle Scholar11. Merion RM. When is a patient too well and when is a patient too sick for a liver transplant? Liver Transpl. 2004;10:S69-73. [PMID: 15382215] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Sandeep Mukherjee, MD, MPH; Michael F. Sorrell, MDAffiliations: From the University of Nebraska Medical Center, Omaha, NE 68198-3285.Disclosures: None disclosed.Corresponding Author: Michael F. Sorrell, MD, Section of Gastroenterology and Hepatology, University of Nebraska Medical Center, 983285 Nebraska Medical Center, Omaha, NE 68198-3285; e-mail, msorrell@unmc.edu.Current Author Addresses: Drs. Sorrell and Mukherjee: Section of Gastroenterology and Hepatology, University of Nebraska Medical Center, 983285 Nebraska Medical Center, Omaha, NE 68198-3285. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoImmediate Listing for Liver Transplantation Versus Standard Care for Child–Pugh Stage B Alcoholic Cirrhosis Claire Vanlemmens , Vincent Di Martino , Chantal Milan , Michel Messner , Anne Minello , Christophe Duvoux , Thierry Poynard , Jean-Marc Perarnau , Marie-Anne Astrid Piquet , Georges-Philippe Pageaux , Sébastien Dharancy , Christine Silvain , Sophie Hillaire , Gérard Thiefin , Jean-Pierre Vinel , Patrick Hillon , Estelle Collin , Georges Mantion , and Jean-Philippe Miguet , and the TRANSCIAL Study Group* Correction: Immediate Listing for Liver Transplantation for Alcoholic Cirrhosis Metrics Cited byCare of Chronic Liver DiseaseCorrection: Immediate Listing for Liver Transplantation for Alcoholic Cirrhosis 3 February 2009Volume 150, Issue 3 Page: 216-217 Keywords Alcoholics Alcohols Cirrhosis Death rates Gastroenterology and hepatology Liver diseases Liver transplantation Mortality Systemic diseases Transplantation ePublished: 3 February 2009 Issue Published: 3 February 2009 Copyright & PermissionsCopyright © 2009 by American College of Physicians. 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