Mandates and best practices for liver transplant in alcohol-associated liver disease: is it time for regulation and national policy reform?

Description

Alcohol-associated liver disease (ALD) has surged as an indication for transplant, increasing over 5-fold in the past 20 years, and is now the #1 indication for transplant in the US. Early (i.e. without mandated period of abstinence) transplant has partly contributed to this trend, and is now the fastest growing indication for transplant. Despite the growing dominance of ALD for transplant, there is no standardization of practice or policies across transplant centers, and there is lack of alcohol-specific quality metrics from regulatory organizations, which could be contributing to disparities in transplant access and outcomes.   Alcohol-associated liver disease (ALD) has surged as an indication for transplant, increasing over 5-fold in the past 20 years, and is now the #1 indication for transplant in the US. Early (i.e. without mandated period of abstinence) transplant has partly contributed to this trend, and is now the fastest growing indication for transplant. Despite the growing dominance of ALD for transplant, there is no standardization of practice or policies across transplant centers, and there is lack of alcohol-specific quality metrics from regulatory organizations, which could be contributing to disparities in transplant access and outcomes.