JLE

Hépato-Gastro & Oncologie Digestive

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Ethical analysis of liver transplantation for severe alcoholic hepatitis Volume 21, issue 2, Février 2014

Authors
1 Hôpital de Montauban,
pôle médico-chirurgical,
BP 765,
82013 Montauban cedex,
France
2 Hôpital Saint-Eloi,
service d’hépato-gastroentérologie,
80 rue Augustin Fliche,
34295 Montpellier Cedex 5,
France
* Tirés à part

Patients with severe alcoholic hepatitis with non-response to steroids can be selected for liver transplantation. They have good survival and a low rate of recidivism but it is an ethical dilemma. Because there is no alternative treatment for liver transplantation for most patients with end-stage liver disease, the 6-month rule could be lethal in some circumstances. Consequently, we advocate a flexible approach to clinical decision making for the transplant professional caring for an alcoholic patient who has resumed drinking and provide specific guidelines for patients with severe alcoholic hepatitis management including ethical issues with “preview method” associated with liver transplantation. Preview method is a new method to clarify the thinking of situation which are not only scientific.