Alcohol abstinence criteria for living liver donors and their organ recipients

PURPOSE OF REVIEW: Psychosocial criteria for live organ donors and their organ recipients are important for their safety and welfare. In liver transplantation, alcohol use by either party is problematic. This article reviews this topic and offers guidance for donor and recipient selection. 

RECENT FINDINGS: The '6 month rule' for alcohol abstinence is the standard approach for many hospitals when evaluating patients for transplant candidacy. Recently, clinicians have explored the rationale for this quantitative rule and discovered additional factors that can help to predict the risk for post-transplant alcohol relapse. Guidance for live liver donors is a newer topic and is thus less explored in the literature; however, one report does give specific direction, with the overarching principle that all living donors should, themselves, satisfy the psychosocial criteria for placement on the transplant waiting list. 

SUMMARY: Ethical organ stewardship requires that live donors take care of their bodies before donation and that organ recipients take care of the gift they receive. Alcohol can negatively influence liver function as well as decision making by donors and recipients; thus, transplant teams must take a paternalistic approach when evaluating these individuals in an effort to optimize their safety, as well as transplant outcomes.