People with higher MELD scores are generally offered donated livers first. Time spent on the liver transplant waiting list is used to break ties among people with the same MELD scores and blood types. Some liver conditions, such as liver cancer, may not result in a person getting a high MELD score.
Throughout the United States, patients waiting for liver transplants are prioritized based on the severity of their illness, as measured by what's called the Model for End-Stage Liver Disease (MELD) score. The score uses blood tests to determine how urgently you need a liver transplant within the next three months.
Medical Grounds
Alcoholics historically have been considered unsuitable for liver transplantation because of their presumed high risk of relapse to excessive drinking after transplantation.
It's usually recommended when the liver has been damaged to the point that it cannot perform its normal functions. This is known as liver failure or end-stage liver disease. The liver can become gradually damaged as a result of illness, infection or alcohol.
Excessive brain swelling, or severe infection are signs that a patient may not be able to withstand a liver transplant.
The thinking then — and among proponents of the practice today — was that six months of abstinence gave a patient's liver time to heal and, thus, avoid a transplant. If that didn't work, the patient would have proven they can stay sober and would not return to drinking after a transplant.
Patients with severe alcohol-related liver disease who do not respond to medical therapy have a life expectancy low enough that the only therapeutic option associated with a survival benefit is liver transplantation.
The 1-year and 5-year actuarial survival rates following liver transplantation for patients with alcoholic liver dis- ease are 82% and 68%, respectively, in the United States and 85% and 70%, respectively, in Europe.
It's generally not reversible, but stopping drinking alcohol immediately can prevent further damage and significantly increase your life expectancy. A person who has alcohol-related cirrhosis and doesn't stop drinking has a less than 50% chance of living for at least 5 more years.
Waiting time for your liver transplant can vary from a single day to months or years, until a suitable donor is available. While waiting for a transplant, you will return to the Royal Prince Alfred Hospital for regular follow-ups (usually monthly).
The cumulative incidence of wait-list mortality in frail vs nonfrail candidates at 6 months was 8.0% (23 of 290) vs 4.0% (33 of 818), at 1 year was 16.5% (48 of 290) vs 8.4% (68 of 818), and at 3 years was 32.0% (93 of 290) vs 17.0% (139 of 818).
You may not be able to have a transplant if you: Have a current or chronic infection that can't be treated. Have metastatic cancer. This is cancer that has spread from its main location to 1 or more other parts of the body.
The minimum requirements to qualify for a liver transplant are: That you have clinical signs of liver failure or primary liver cancer. That you are well enough to have the surgery and recovery. That you are not considered at risk of future alcohol or drug abuse.
Avoid alcohol
If your liver transplant was due to an alcohol-related disease, you must never drink alcohol again as you risk harming your transplanted liver. This also applies if alcohol was thought to have contributed to your liver disease, even if it was not the main cause.
Alcoholic cirrhosis of the liver, which is characterized by severe scarring due to the heavy use of alcohol, is the major cause of end-stage liver disease. For those afflicted with cirrhosis, a liver transplant often offers the only possibility for survival.
Between 10 and 20 percent of heavy drinkers develop cirrhosis, usually after 10 or more years of drinking. Anything that damages the liver over many years can lead the liver to form scar tissue.
Survival rates of 70% are reported both at 2 years and at 10 years. Alcoholic hepatitis is a precirrhotic lesion; progression to cirrhosis is observed more commonly in women, in individuals with severe disease and in those who continue to drink.
Persons with cirrhosis should be referred for a liver transplant evaluation if any of the following criteria are met: (1) MELD score is greater than or equal to 15, (2) complication due to cirrhosis (e.g. ascites, variceal hemorrhage, or hepatic encephalopathy), or (3) diagnosis of hepatocellular carcinoma within Milan ...
On analysis of seven studies, pooled prevalence of self-reported alcohol relapse was 26.3% (18.0–36.7%) over median (range) follow-up of 6.0 (3.7–8.3) years, with annual alcohol relapse rate of 4.7% (3.0–6.4%) for any alcohol use and 2.9% (0.5–5.3%) for heavy alcohol use.
The age of recipients has steadily increased since the 1980s, from 50 years to more than 60 years10,12 and currently is above 70 years. In our study, this increase in the mean age of LT recipients has occurred gradually from 50.4 years in 2007 to 54.2 years in 2016.
Liver transplant can have excellent outcomes. Recipients have been known to live a normal life over 30 years after the operation.
While waiting on the list patients are advised to stay as healthy as possible by eating a healthy balanced diet, taking regular exercise, completely avoiding alcohol, not smoking etc. An average waiting time for a liver transplant is 149 days for adults and 86 days for children.