Severe alcoholic hepatitis (AH) portends a high risk of mortality with mortality rates of 30-50% at 28 days and up to 70% at 6 months.^1,2 Until recently, early LT for severe AH was not undertaken with any significant frequency, given most transplant centers required a period of abstinence prior to LT. Mathurin et al. conducted a pivotal prospective, multicenter study that showed early LT for severe AH that did not respond to medial therapy in the absence of a required period of abstinence improved survival.³ Given this data and other studies, including a multicenter retrospective study in the United States, the American Association for the Study of Liver Diseases (AASLD) guidance suggests LT may be considered in carefully selected patients with favorable psychosocial profiles in severe AH not responding to medical therapy.

中文翻译：

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急于为酒精性肝炎进行早期肝移植——潜在的经济影响

严重酒精性肝炎 (AH) 预示着高死亡率，28 天死亡率为 30-50%，6 个月死亡率高达 70%。^1,2直到最近，对于严重 AH 的早期 LT 并没有以任何显着频率进行，因为大多数移植中心在 LT 之前需要一段时间的禁欲。马图林等人。进行了一项关键的前瞻性多中心研究，该研究表明在没有规定的禁欲期的情况下对药物治疗无反应的严重 AH 的早期 LT 可提高生存率。^3个鉴于该数据和其他研究，包括在美国进行的一项多中心回顾性研究，美国肝病研究协会 (AASLD) 指南建议，在对药物治疗无反应的严重 AH 患者中，可考虑对具有良好社会心理特征的精心挑选的患者进行 LT治疗。