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Evid Based Med 18:21-22 doi:10.1136/ebmed-2012-100541
  • Therapeutics
  • Cohort study

In patients with a first episode of severe alcoholic hepatitis non-responsive to medical therapy, early liver transplant increases 6-month survival

  1. Michael R Lucey
  1. Division of Gastroenterology and Hepatology, Department of Medicine, University of Wisconsin-Madison, Madison, Wisconsin, USA
  1. Correspondence to: Michael R Lucey
    University of Wisconsin-Madison, 4245 UW Med Fndtn Centennial Bldg, 1685 Highland Ave Madison, WI 53705, USA; mrl{at}medicine.wisc.edu

Commentary on:

Context

In its most severe form, alcoholic hepatitis is associated with jaundice, coagulopathy, leucocytosis and rapid deterioration to death.1 When used in conjunction with abstinence from alcohol, corticosteroids improve 6-month survival for such severely affected patients.2 Treatment failures are identified after 7 days of therapy, using a simple mathematical instrument (http://www.lillemodel.com).3 Patients with alcoholic hepatitis who are unresponsive to medical management have a dire 6-month mortality.

Widely-used selection rules exclude patients with alcoholic hepatitis from liver transplantation (LT) unless they demonstrate 6 months of abstinence from alcohol.4 ,5 The study by Mathurin et al used …

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