Skip to main content

It has been known for centuries that alcohol is directly toxic to the liverAlcoholic liver disease is a major cause of chronic liver disease and cirrhosis in the United States, and most of the civilized world.  In many circumstances, patients with alcoholic liver disease also carry the diagnosis of alcoholism. 

Since the inception of liver transplantation back in the early 1980s, there has been special concern for patients with alcoholic liver disease and alcoholism that are evaluated for liver transplant.  The major concern both for the physicians and surgeons, as well as the general public, relates to the return of drinking after a successful liver transplant. 

For many years, most liver transplant programs have evaluated the patients with alcohol related liver disease, but have use what is called the “six month rule” in evaluating these patient.  The six month rule states that the patients with alcohol related liver disease most first be abstinent from all alcoholic beverages for minimum of six months prior to being evaluated for liver transplant.  During the six months, they need to participate in an active relapse prevention program, such as Alcoholics Anonymous or some other alcohol rehab program.  The patients that do not satisfy the six month rule will not be deemed suitable for liver transplant.

We have taken a slightly different approach to the six month rule.  Researching it extensively, there was no clinical research that indicates that being abstinent from alcohol for six months or greater will predict alcohol use after transplant.  We have developed a strategy to carefully evaluate each patient on a case by case basis, and determine whether or not they need a period of abstinence prior to liver transplant.  We have worked diligently putting a multispecialty team together including hepatologists, liver transplant surgeons, liver transplant social workers with experience in substance abuse counseling, psychiatry, as well as specialist in addiction medicine.

Within this framework, we have developed a dedicated team to evaluate such patients with alcoholism and alcoholic liver disease.  Working very closely with a number of alcohol rehabilitation centers around the state and region, we have been able to successfully transplant patients with alcohol related liver disease while phasing out the six month rule. This has allowed us to evaluate more patients with alcohol related liver disease that otherwise would not have received a chance at receiving a liver transplant. The percent of patients returning to abusive alcohol use is exquisitely low.

Obesity and Fatty Liver Disease

Obesity, and all of its related complications, is more serious than most adults in America believe. More than one-third (34.9% or 78.6 million) of U.S. adults are obese. Obesity-related conditions include heart disease, stroke, type 2 diabetes, fatty liver disease, and certain types of cancer, are some of the leading causes of preventable death. We are seeing an increase in the number of young children and adolescents developing obesity, and all of the related complications.

The cost of obesity is staggering, with annual medical cost of obesity exceeding $147 billion in 2008 U.S. dollars. The medical costs for people who are obese were $1,429 higher than those of normal weight.

Dr. Galati and the Liver Specialists of Texas team are dedicated to evaluate, treat, and manage all aspects of obesity and non-alcoholic fatty liver disease (NAFLD and NASH), including the complication of cirrhosis and liver failure. Developing a customized plan of care for each patient they see is their objective.

Liver Transplant Resources

Dr. Galati has been involved in Liver Transplantation since 1989. As Medical Director for the Center for Liver Disease and Transplantation at Houston Methodist Hospital, Dr. Galati has cared for thousands of patients with advanced liver disease. In those with the most severe form of advanced liver disease and cirrhosis, liver transplantation is a life-saving surgery. For more information on liver transplantation, click here.

Indications for liver transplant include:

Online LIVER Second Opinion

  • 1

    From the comfort of your home, without the need to spend additional money on travel, lodging, and food, receive and expert second opinion from the expert physicians at Liver Specialists of Texas

  • 2

    There are five steps in the process of requesting a second opinion. We anticipate the steps will take you about 30-65 minutes to complete.

  • 3

    Have your medical records or those of your loved one on hand as you fill out the medical history questionnaire portion of the online process. The medical history questionnaire is detailed so having medical records to quickly reference will help make the process more efficient.

  • 4

    To start the process of an Online Liver Second Opinion, please fill out the initial contact form and fax back to our office. A representative from our office will call you for additional details.