Division of Gastroenterology and Hepatology, Department of Medicine, The University of Michigan, Ann Arbor, MI, USA.
Division of Gastroenterology and Hepatology, Department of Medicine, The Pennsylvania State University- Milton S. Hershey Medical Center, Hershey, PA, 17033, USA.
Dig Dis Sci. 2020 Jun;65(6):1608-1614. doi: 10.1007/s10620-020-06159-9.
Although alcohol-associated liver disease has long been a major component of the liver disease landscape, it was overshadowed by chronic hepatitis C until recently. Nevertheless, with the declining incidence of hepatitis C in the wake of highly effective antiviral therapy, attention has shifted to the increasing burden of alcohol-associated liver disease. The incidence of advanced alcohol-associated liver disease, including acute alcoholic hepatitis and alcohol-associated cirrhosis, is rising in parallel with increasing rates of alcohol use disorders. As a result, alcohol-associated liver disease is now one of the most common indications for liver transplantation. Rates of liver transplantation for acute alcoholic hepatitis are rising as well in spite of the sparse guidance regarding candidate selection, counseling, postoperative care, long-term follow-up, and other best practices. To this day, liver transplant for acute alcoholic hepatitis remains a hotly debated clinical controversy.
虽然酒精性肝病长期以来一直是肝病领域的主要组成部分,但直到最近它才被慢性丙型肝炎所掩盖。然而,随着高效抗病毒疗法的出现,丙型肝炎的发病率下降,人们的注意力转向了酒精性肝病负担的增加。包括急性酒精性肝炎和酒精性肝硬化在内的晚期酒精性肝病的发病率与酒精使用障碍的发生率呈平行上升趋势。因此,酒精性肝病现在是肝移植最常见的适应症之一。尽管关于候选者选择、咨询、术后护理、长期随访和其他最佳实践的指导意见很少,但急性酒精性肝炎的肝移植率也在上升。时至今日,急性酒精性肝炎的肝移植仍然是一个颇具争议的临床争议。