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June 15, 1994

Alcohol's Threat to Liver Transplant Recipients May Be Overstated, Suggests Retrospective Study

JAMA. 1994;271(23):1815. doi:10.1001/jama.1994.03510470019006

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DISCRIMINATION against alcoholics in liver transplant programs may be unwarranted, or at least excessive.

Most transplant programs exclude alcoholics who cannot convince clinicians that they will stay on the wagon. This policy is based on the theory that relapse in alcohol addiction is voluntary behavior, and that alcohol consumption damages the grafted liver, leading to a willful waste of a scarce resource.

Fully 80% of liver transplant programs won't even consider current heavy drinkers; 23.9% won't take patients who abused alcohol in the past 6 months, and 58.7% say drinking in the past 6 months is a "relative" contraindication (Psychosomatics. 1993;34:314-323).

Rejection and Death Not Higher  However, alcoholics who do start drinking again after transplantation do not have increased rates of histological abnormalities, graft rejection, or death, according to a retrospective study conducted at the University of Michigan Medical School, Ann Arbor. All patients who had a history of alcohol

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