Ethical Considerations of Transplantation and Living Donation for Patients with Alcoholic Liver Diseases

Singhvi, Ajay; Welch, Alexandra N.; Levitsky, Josh; Singhvi, Deepti; Gordon, Elisa J.

doi:10.1001/journalofethics.2016.18.2.sect1-1602

Cited by 16 publications

(2 citation statements)

References 40 publications

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“…The 6-month pre-transplant rule was effective for various patients, including those of this study; however, it seems insufficient: having 6 months or more of abstinence was not a protective factor for the maintenance of post-transplant abstinence in 5 cases. This data corroborates studies that question the efficacy of this rule in predicting the risk of relapse (Donnadieu-Rigole et al 2015;Singhvi et al 2016), reinforcing the importance of having a more systemic analysis of the patient, with evaluation of the motivation for the use, maintenance, and abstinence of alcohol, which will favor the pre-and posttransplantation interventions of the team, in order to help with the specific difficulties of the patient.…”

Section: Categoriessupporting

confidence: 79%

“…Maintaining alcohol abstinence after transplantation is complex and cannot be limited to these factors alone. An effective multidisciplinary evaluation, including a specialist in chemical dependency, effective communication between team members, and addressing the psychosocial issues of transplant patients, may be the way to protect patients from the risk of alcoholic relapse (EASL 2016;Singhvi et al 2016).…”

Section: Categoriesmentioning

confidence: 99%

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Psychosocial Factors Related to Post-liver Transplantation Alcohol Abstinence

Rocha

Seidl

2020

Trends in Psychol.

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The study aimed to identify protective and risk factors related to alcoholic relapse and non-relapse in the post-transplantation period, in people with alcoholic liver disease that had undergone liver transplantation. The study was carried out with 15 adult transplant patients, with a mean age of 52.2 years, the majority male. The method includes a medical record analysis, a predivision of the participants into two groupsrelapse group (RG, 5 participants) and no relapse group (NRG, 10 participants)-and the application of the interview script, Hospital Anxiety and Depression Scale, and Anticipatory Coping Skills Inventory for Abstinence from Alcohol and Other Drugs (IDHEA). The results pointed that there was no statistically significant difference between the RG and NRG in the mean scores of anxiety, depression, and the IDHEA. Qualitative and quantitative analyses identified that the risk factors for relapse were the following: history of alcohol dependence, family problems, low ability to refuse alcohol, problems with post-surgery work activity, and association of disorders such as anxiety and depression. The work with this population should be preventive, continuous, and multiprofessional, with psychological and team interventions based on evidence and effective in the pre-and post-liver transplantation phases. Resumen El estudio tuvo como objetivo identificar factores protectores y de riesgo relacionados con la recaída y la no recaída alcohólica en el postrasplante, en personas con enfermedad hepática alcohólica sometidas a trasplante de hígado. El estudio fue realizado con quince adultos transplantados, con una media de edad de 52,2 años, la mayoría hombres. El método incluyó la análisis de prontuarios, la división de los participantes triados en dos grupos-recaída (GR, 5 participantes) y no recaída (GNR,

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Section: Categoriessupporting

confidence: 79%

Section: Categoriesmentioning

confidence: 99%

Psychosocial Factors Related to Post-liver Transplantation Alcohol Abstinence

Rocha

Seidl

2020

Trends in Psychol.

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The evolving paradigm of alcohol‐associated hepatitis and liver transplantation

Horwich¹,

Leven²,

Winters³

et al. 2022

Clinical Liver Disease

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Patients' Perspectives on Early Liver Transplantation in Alcohol‐Related Liver Disease

et al. 2019

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Liver transplant programs in Canada require a period of 6 months of abstinence from alcohol before considering a patient with liver disease secondary to alcohol for transplantation. Although some studies have demonstrated good outcomes following a transplant in carefully selected patients before the 6‐month abstinence period has been met, there have been arguments against this, including the claim that the public has a general negative perception of those with alcohol dependence. We performed a multicenter cross‐sectional survey to determine the perception of people in British Columbia, Canada, toward liver transplantation in patients with liver disease due to alcohol who have not demonstrated the capacity to remain abstinent from alcohol for 6 months. A total of 304 patient questionnaires were completed, and 83.1% agreed with a period of abstinence of 6 months. In those patients who were unlikely to survive 6 months without a transplant, 34.1% of respondents agreed with, 44.1% did not agree with, and 21.4% were neutral about, early transplantation; 42.8% would have less trust in the process of transplantation if a period of abstinence was not maintained, but relaxing the requirement for an abstinence period would not have an impact on the majority's decision to donate organs. Only 30.5% would support abandoning the abstinence criteria. Conclusion: Among patients followed at general gastroenterology, medicine, or transplant clinics, there is a willingness to relax the criteria in selected patients unlikely to survive without a transplant, although a general consensus remains in support of the existing 6‐month alcohol abstinence rule. A larger scale survey of all provinces in Canada would be required to assess support for such a change in policy.

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Ethical Considerations of Transplantation and Living Donation for Patients with Alcoholic Liver Diseases

Cited by 16 publications

References 40 publications

Psychosocial Factors Related to Post-liver Transplantation Alcohol Abstinence

Psychosocial Factors Related to Post-liver Transplantation Alcohol Abstinence

The evolving paradigm of alcohol‐associated hepatitis and liver transplantation

Patients' Perspectives on Early Liver Transplantation in Alcohol‐Related Liver Disease

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