However, most alcoholics do not return to alcoholic drinking after liver transplant, although many do drink at least occasionally.
Assigning Alcoholics to the Waiting List for Livers
Around 5,000 liver transplants are performed each year in the United States. Organs are allocated according to a system that evaluates a person’s chance of survival over the next three months by assigning a MELD score, a number based on three blood tests. Liver transplants are done for many reasons unrelated to alcohol use. However, alcohol abuse often is assumed by non-medical personnel when a person needs a liver transplant. Of the people who receive donated livers each year, only a small percentage are alcoholics.
How Alcohol Causes Liver Damage
Alcoholism and hepatitis are the main causes of cirrhosis in the United States, the Merck Manual reports. Alcohol, a toxin, destroys liver cells, leading first to inflammation and, in up to 70 percent of alcoholics, the National Institute on Alcoholism and Alcohol, NIAAA, reports, progressing to fibrosis, where normal tissue is replaced with scar tissue. Scar tissue disrupts blood flow through the liver, interfering with its main tasks of cleansing the blood of toxins, breaking down waste products and producing clotting factors that stop bleeding.
The Number of Liver Transplants Done for Alcoholism
Between 1992 and 2001, over 41,000 liver transplants were performed in the United States, with 12.5 being performed for alcoholism and another 5.8 performed for alcohol use and concurrent hepatitis C infection, the NIAAA states. Alcohol is not the main reason for liver transplantation in the United States. Hepatitis C is the cause of more liver transplants. Alcoholics are not refused liver transplants, but must undergo testing and counseling to receive a liver, in addition to a period of abstinence.
The Regulations for Alcoholics to Have a Liver Transplant
For an alcoholic to be considered for liver transplant, he must be free from alcohol use for at least six months at most transplant centers. This is not a UNOS requirement; each center is allowed to set their own standards for transplant.
Statistics on Drinking After Transplant in Alcoholics
Statistics show that many prior alcoholics do drink alcohol after transplant, but not all return to alcoholic drinking. A study done by the University of Pittsburgh Medical Center in 2005 found that 42 percent of alcoholics had had at least one drink five years after transplant, with 26 percent of those who returning to heavy drinking and 22 percent drinking regularly.
Deciding Whether Alcoholics Should be Allowed to Have Liver Transplants
Much debate exists on whether alcoholics, who have caused their disease, should be allowed to have liver transplants, since donated liver, like all organs, are in short supply. People with hepatitis B or C, however, are much more likely to have recurrence of their disease and to lose their transplanted liver to their disease, the NIAAA explains. Serious relapses in alcoholics that destroy the new liver are uncommon, and liver transplant patients are less likely to relapse than those who go through counseling for alcoholism.
Sharon Perkins - Sharon is an RN with over 20 years experience in maternal child health, oncology, and ophthalmology. She was the RN coordinator for an ...
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