Validation of the Procedure of Early Liver Transplantation in Alcoholic Hepatitis Resisting to Medical Treatment (QuickTrans)
Alcoholic Hepatitis, Alcoholic Cirrhosis
About this trial
This is an interventional treatment trial for Alcoholic Hepatitis focused on measuring Alcoholic hepatitis, Liver transplantation, Alcohol relapse, Alcoholic cirrhosis
Eligibility Criteria
Inclusion Criteria (Group A):
- Age > 18 years
- Maddrey score > 32
- Liver biopsy confirming the diagnosis of alcoholic hepatitis
- Non-response to medical treatment: Lille score ≥ 0.45 at day 7, or early worsening of liver function (MELD score > 25) despite a low Lille score (< 0.45)
- Hospitalization stay < 1 month
- Algorithm score ≥ 220/250.
Inclusion Criteria (Group B):
- Age >18 years
- Diagnosis of alcoholic cirrhosis
- Alcoholic withdrawal of 6 months minimum before inscription on the transplant list
- MELD score ≥ 15 for patients with hepatocellular carcinoma responding to Milan criteria (1 node < 5 cm or 3 nodes < 3 cm)
- MELD score ≥ 20 preferably for patients not displaying hepatocellular carcinoma and that did not obtain an "expert" component
- No recommendation of MELD score for patients having obtained an "expert" component
Non-inclusion Criteria (Group A and B):
- Bacterial or viral infection uncontrolled by medical treatment
- Fungal or aspergillosis uncontrolled infection
- Hepatocellular carcinoma or invasive cancer
- Positive test for HBsAg, Positive test for HIV,Positive PCR for HCV
- Portal thrombosis
- Pregnancy or breast-feeding woman
Sites / Locations
- UZA
- ULB, Erasme
- Hospital Sart Tilman
- Univesity hospital
- University hospital
- University hospital
- Hôpital Jean Verdier (AH-HP)
- University hospital
- University hospital
- Univesity hospital
- Hospital Antoine Béclère (Assistance Publique des Hôpiaux de Paris)
- Hôpital Beaujon (AH-HP)
- Hôpital Henri Mondor (AP-HP)
- University hospital
- University hospital
- University hospital
- University hospital
- University Hospital
- University hospital
- University hospital
- University hospital
- Hôpital Saint Antoine (AP-HP)
- Hôpital de la Pitié-Salpétrière (AP-HP)
- Hôpital Cochin (AH-HP)
- University Hospital
- University hospital
- University hospital
- University hospital
- University Hospital
- University hospital
- Hôpital Paul Brousse (AH-HP)
Arms of the Study
Arm 1
Arm 2
Other
Other
Transplantation of alcoholic hepatitis
Transplantation for alcoholic cirrhosis
Patients of this arm will be selected for early liver transplantation for severe alcoholic hepatitis not responding to medical therapy. Selection process will be based on a specific algorithm and follow-up time will be 2 years
Patients of this arm will be selected for liver transplantation for alcoholic cirrhosis using an abstinence period of 6 months. Outcome of these patients will be compared to that of patients transplanted for severe alcoholic hepatitis.