Alcoholic Liver Disease (ALD) represents the second most common indication for Liver
Transplantation (LT) worldwide. Outcomes of LT for ALD are comparable with those of liver transplantation
for other aetiologies of liver disease; however, it's still considered a controversial indication
to LT, mainly because ALD is considered a self inflicted disease, and for the risk of relapse after LT.
Most transplant programs require 6 months of abstinence in order to consider a patient suitable for LT,
however the role of the length of pre transplant abstinence as predictor of alcohol relapse after LT is
still controversial. A psycho-social assessment to establish the likelihood of long-term abstinence after
LT should be performed in patients with ALD potential candidates for LT. Acute alcoholic hepatitis is considered a contraindication
to transplantation in most transplant centers. However, early LT, in selected patients, with a first episode of
severe alcoholic hepatitis not responding to medical therapy, has been shown to improve survival. Further studies are
needed to better assess the risk of alcohol relapse after LT in patients with acute alcoholic hepatitis.