Con: Alcohol Abstinence does not Impact Post-Transplant Outcomes in ALD and AAH

Purpose of Review: In this debate, we will argue that abstinence remains a relevant, evidence-based, and ethically necessary goal after LT for ALD not only because of its effect on graft and patient survival, but because of its broader impact on risk stratification, healthcare equity, and long-term quality of life. Recent Findings: Abstinence is a critical goal after LT for ALD and AH because: 1) alcohol relapse after LT for ALD is the strongest predictor of graft failure and mortality, 2) alcohol relapse after LT for ALD worsens health risks beyond the liver, 3) abstinence upholds ethical principles and public trust. Summary: In this debate, we have argued that abstinence remains a relevant, evidence-based, and ethically necessary goal after LT for ALD that is a key driver of positive post-LT outcomes.