Journal du pancréas Libre accès

Abstrait

Severe Acute Alcoholic Hepatitis and Liver Transplant: Ethical and Legal Responsibility

Aiman Obed, Abdalla Bashir, Anwar Jarrad, Steffen Stern

Background Since more than 30 years ago, it is well understood that the survival of patients with a severe stage of hepatic damage due to alcohol, is no longer influenced by abstinence. Often, liver transplantation is the only way for these patients to survive. The arbitrary exclusion of these critically ill patients from an adequate therapy, in itself, is a substantial violation of the human rights of the patients and the national constitutional law in several countries. Not transplanting patients with alcoholic hepatitis simply because they failed to demonstrate long-term abstinence appears to be very hard to defend and preserve, particularly in view of the high fatality risk without LT. SAAH patients deserve to be included in the life saving organ donation system and deserve to be treated equally. The outcome of patients transplanted for severe acute alcoholic hepatitis is at least as good as patients transplanted for other diagnoses. Summary Emerging studies have verified the excellent survival advantage of LT in carefully selected patients with severe alcoholic hepatitis who failed medical therapy. Conclusion Patients with severe acute alcoholic hepatitis should have legitimate equal access to LT compared to other LT candidates.