Liver Transplantation for Alcoholic Liver Disease

Alcohol consumption, in particular harmful alcohol use related to Alcohol Use Disorders (AUD) accounts for 3.8% of global mortality and 4.6% of Disability-Adjusted Life Years (DALYs) worldwide [1]. A total of 9.5% of alcohol-related DALYs is due to Alcoholic Liver Disease (ALD) [2]. At present alcohol still represents the most common cause of liver cirrhosis in the Western countries [3]. The development of ALD is influenced by environmental and host factors other than AUD. In particular, the duration of alcohol abuse, the drinking pattern and the alcohol amount have been reported as the most important factors for ALD. However the disease profile induced by comparable levels of consumed alcohol shows a high individual variability in terms of severity and rapidity of progression. It has been reported that nutritional status, gender, ethnicity, iron overload, co-existing metabolic syndrome, chronic viral co-infections (particularly hepatitis B and C viruses), polymorphisms of genes involved in alcohol metabolism and in the regulation of endotoxin-mediated cytokines release are important additional elements [4]. All these factors can contribute to the progression from the early stage of ALD (fatty liver disease/ steatosis) to steato-hepatitis, fibrosis, cirrhosis and its complications (e.g. hepatocellular carcinoma).