alcoholic%20liver%20disease
ALCOHOLIC LIVER DISEASE
Alcoholic liver disease diagnosis is suggested by an established history of habitual alcohol intake of sufficient length and intensity.
Toxic daily threshold of alcohol consumption is 40-80 g for males and 20-40 g for females for 10-12 years.
Signs of alcohol abuse and hepatic injury include malnutrition and muscle wasting, cutaneous telangiectasia, palmar erythema, finger clubbing, Dupuytren's contracture, peripheral neuropathy, parotid gland enlargement and signs of gynecomastia and hypogonadism may also be present.

Surgical Intervention

Liver Transplantation

  • Patients with advanced alcoholic liver disease (ALD) or end-stage liver disease secondary to alcoholic cirrhosis may be considered for liver transplantation
    • Sick patients unable to complete rehabilitation therapy may also be considered for liver transplantation and can finish their rehabilitation therapy after surgery
  • Survival rate is comparable to patients who had transplantation from nonalcoholic liver disease
    • Patients classified as Child-Pugh C and/or MELD >15 gain survival benefit
  • Carefully evaluate the patient for:
    • Ability and commitment to abstain from alcohol, eg abstinence from alcohol of a minimum of 6 months
    • Damage to other organs (eg heart, brain)
    • Malignancy in the upper gastrointestinal tract or the upper airways
  • Immunosuppressive agents (eg Sirolimus or Everolimus) should be used at the lowest effective dose for prevention of graft rejection  
  • Screen posttransplant patients during each follow-up for use of alcohol and other substances (eg cannabis, tobacco) 
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