Liver Transplantation

by Michael_Koger

There are many controversies over the use of liver transplantation for patients who have alcoholic hepatitis.

Individuals with advanced alcoholic hepatitis may progress to failure of the liver, and the only solution in some cases is transplantation. As with any organ transplant, there is a complex procedure to arrange for it. The most common reason for liver transplantation in the United States is cirrhosis, and that medical condition may result from chronic hepatitis C infection or a long history of drinking too much [1, 2].

Since there is a waiting list to perform the procedure, some have questioned whether a person who consumes too much alcohol should have the privilege to undergo liver transplantation. Many communities across the globe believe that a person must take responsibility for his or her medical condition. Hence, the controversy over this matter has both social and medical elements [1].

Social Controversies

Some countries, in fact, require that these clients abstain from alcohol intake for at least six months in order to consider them for the transplant waiting list.  The rationale for this approach, of course, is that an individual who still drinks heavily will make a poor candidate for the procedure.  In other words, some will question the use of such an operation when the habit can subsequently damage the new organ [1].

Who Gets a Transplant?

In any event, the process to obtain this operative procedure begins with a referral from a physician to a transplant center.  The patient has to get a thorough medical evaluation, and the team of health care workers will include transplant surgeons, liver specialists, nurses, transplant coordinators, social workers, and a psychiatrist [2].

In the United States, those with end-stage liver disease and risk of death within a week will have priority for the procedure.

Several possibilities may interfere with execution of the surgery.  First, the patient can change his or her intent and decline an offer to have the operation.  Second, the medical center may decide that the person is not an acceptable candidate when certain other medical conditions are present.  These include acquired immune deficiency syndrome, advanced disease of the heart or lungs, or cancer outside of the liver [2].

Those with alcohol or other substance use disorders will not always gain acceptance for the operation.  Moreover, individuals with infection throughout the body will likely get a declination.  Finally, lack of adequate psychosocial support or inability to comply with a treatment program may also be reasons for admission denial [2].

Most of these transplantations go smoothly, and at least four-fifths of these patients are doing well a year after the procedure [2].


The human liver is a remarkable internal organ, and it has the capacity to regenerate itself when its cells incur damage.  However, when it ceases to adequately function, the person cannot survive.


  1. Dugum, M., Zein, N., McCullough, A., et al.  (2015).  Alcoholic hepatitis:  Challenges in diagnosis and management.  Cleveland Clinic Journal of Medicine, 82, 226-236.
  2. National Institute of Diabetes and Digestive and Kidney Diseases.  (2010).  Liver transplantation.  Retrieved April 30, 2015.
  3. The photo shows a microscopic view of human liver and Mallory bodies, which are present in some patients who have alcoholic hepatitis.


The information contained in this article is for educational purposes only and should not be used for diagnosis or to guide treatment without the opinion of a health professional. Any reader who is concerned about his or her health should contact their physician for advice.

Updated: 05/06/2015, Michael_Koger
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