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Old 05-26-2013
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GIT Gastroenterology Q23

A 55-year-old male with cirrhosis is seen in the clinic for follow-up of a recent hospitalization for spon-taneous bacterial peritonitis. He is doing well and finish-ing his course of antibiotics. He is taking propranolol and lactulose. Besides complications of end-stage liver dis-ease, he has well-controlled diabetes mellitus and had a basal cell carcinoma resected 5 years ago. The cirrhosis is thought to be due to alcohol abuse, and his last drink of alcohol was 2 weeks ago. He and his wife ask if he is a liver transplant candidate. He can be counseled in which of the following ways?
A. Because he had a skin cancer he is not a transplant candidate.
B. Because he has diabetes mellitus he is not a trans-plant candidate.
C. He is appropriate for liver transplantation and should be referred immediately.
D. He is not a transplant candidate as he has a history of alcohol dependence.
E. He is not a transplant candidate now, but may be after a sustained period of proven abstinence from alcohol.
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Old 05-26-2013
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He needs to be sober for at least a year i think.. i dont remember the exact time.. but if he shows the can be sober for a lot of time.. then he can receive the transplant.
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Old 05-27-2013
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Quote:
Originally Posted by XpaezX View Post
He needs to be sober for at least a year i think.. i dont remember the exact time.. but if he shows the can be sober for a lot of time.. then he can receive the transplant.
EXactly....

answer is E. He is not a transplant candidate now, but may be after a sustained period of proven abstinence from alcohol.

The patient has advanced cirrhosis with a high risk of mor-tality, as evidenced by his episode of spontaneous bacterial peritonitis. His diabetes and remote skin cancer (since it was a basal cell carcinoma, not melanoma) are not absolute contraindications for liver transplantation, but active alcohol abuse is. The other absolute contraindications to transplantation are life-threatening systemic disease, uncontrolled infections, preexisting advanced cardiac or pulmonary disease, metastatic malignancy, and life-threatening congenital malignancies. Ongoing drug or alcohol abuse is an abso-lute contraindication, and patients who would otherwise be suitable candidates should immediately be referred to appropriate counseling centers to achieve abstinence. Once that is achieved for an acceptable period of time, transplantation can be considered. Indeed, alcoholic cirrhosis accounts for a substantial proportion of the patients who undergo liver transplantation.
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Old 06-02-2013
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Yes it is at least 6 month duration of abstinence before liver transplantation
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