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  • The number of people who got a liver transplant or were put on a transplant waiting list due to alcoholic hepatitis increased dramatically during the pandemic, according to a new study.
  • Alcoholic hepatitis is an inflammatory condition of the liver. It’s typically caused by long periods of regular heavy alcohol use. Binge drinking can worsen this condition.
  • Other alcohol-related liver diseases, such as cirrhosis and liver cancer, can take years to develop.

Heavy drinking during the pandemic might be causing an increased need for liver transplants, researchers reported this week.

They found that the number of people who were put on a liver transplant waiting list or who got a liver transplant due to alcoholic hepatitis was 50 percent higher than what was expected based on pre-pandemic trends.

Alcoholic hepatitis is an inflammatory condition of the liver. It’s typically caused by long periods of regular heavy alcohol use. Binge drinking can worsen this condition.

When the liver processes alcohol, it creates highly toxic chemicals that can trigger inflammation and damage liver cells.

If the damage is severe enough, people may need a liver transplant to survive.

Scientists don’t know why some people who drink heavily develop alcoholic hepatitis and others don’t.

For this study, Michigan Medicine researchers looked at the number of waiting list registrations for a liver transplant and deceased donor liver transplants due to alcoholic hepatitis that occurred during and before the pandemic.

They used waiting list and transplant data from the nonprofit United Network for Organ Sharing for the period March 2020 to January 2021.

They also forecast how many transplants and registrations might have occurred during that same period based on data from a year earlier.

Alcohol sales data came from the Census Bureau Monthly Retail Trade Report.

During the first 10 months of the pandemic, waiting list registrations and liver transplants related to alcoholic hepatitis increased by more than 50 percent, compared with the forecasted numbers.

Dr. Brian Lee,a hepatologist and liver transplant specialist with Keck Medicine of USC, who was not involved in the study, said this large of an increase in the need for liver transplants is “dramatic.”

“I don’t think we’ve ever seen something like this before in the history of liver transplant or liver disease,” he said.

The same trend was not seen with waiting list registrations or liver transplants due to alcohol-related cirrhosis or liver conditions not related to alcohol.

The study, published Oct. 26 in JAMA Network Open, also found a positive association between the number of liver transplants and waiting list registrations and alcohol sales during the pandemic.

“This study provides evidence for an alarming increase in [alcoholic hepatitis] associated with increasing alcohol misuse during COVID-19, and highlights the need for public health interventions around excessive alcohol consumption,” study authors wrote.

Michigan Medicine researchers pointed out that less than 6 percent of people with severe alcoholic hepatitis are on a liver transplant waiting list.

This means the number of Americans with liver damage due to heavy drinking during the pandemic could be much higher.

“[Severe alcoholic hepatitis] is what we’re seeing on an acute level,” Lee said, “but we may be missing a problem that is far more invisible and greater than we think.”

Other alcohol-related liver diseases, such as cirrhosis and liver cancer, can take years to develop. People with those conditions may also not have any symptoms until later in the course of the disease.

Because of the way the new study was designed, researchers can’t say for certain that increased alcohol use during the pandemic was directly responsible for the rise in people needing liver transplants.

However, many health professionals have been concerned about the potential impact of heavy drinking during the pandemic on people’s health.

Lee and his colleagues published a study in July in the Annals of Internal Medicine that found alcohol sales increased 34 percent during the early months of the pandemic.

“The concern when we saw the spike in alcohol sales was that this was going to lead to increased health-related outcomes,” he said. “End stage liver disease and needing a liver transplant is really the end point of that.”

He said the new study provides more evidence of a direct link between increased alcohol sales during the pandemic and severe liver problems.

However, the new study only looked at data through January of this year — and the pandemic is far from over.

So, the research may only be capturing the leading edge of a larger public health crisis.

“Our concern as a liver community is that this might just be the beginning of a wave of alcohol-related liver disease and death due to the pandemic,” Lee said.