Poor Outcomes after Recidivism in Living Donor Liver Transplantation for Alcohol-Related Liver Disease

Abstract

Statistical MethodsData are shown as mean (standard deviation), percentage, or median (25-75 interquartile range). The recidivism and nonrecidivism groups were compared using Fisher's exact test or the chi-square test for categorical data and Student's t test for parametric data or the Mann-Whitney test for nonparametric data. Kaplan-Meier survival curves

Concept and risk factors of alcohol relapse in liver transplant recipients with alcohol‐related aetiologies: A scoping review

“…There were no studies that explored psychosocial consequences of alcohol consumption after LT. Eight studies presented the effects of substance abuse treatment, alcohol contracts and multidisciplinary addiction teams in the prevention or identification of alcohol relapse (Attilia et al, 2018; Choudhary et al, 2022; Donnadieu‐Rigole et al, 2019; Kimura et al, 2017; Lee et al, 2018; Magistri et al, 2019; Masson et al, 2014; Rodrigue et al, 2013). Two of these studies were prospective and random selection was not performed.…”

“…The relapse rates ranged from 9.5% to 45% in studies that defined alcohol relapse as ‘any alcohol consumption after transplantation’, and from 5.8% to 33.3% in studies where alcohol consumption beyond a certain amount or frequency was considered a relapse. Two studies conducted in India reported the lowest alcohol relapse incidence rates (Choudhary et al, 2022; Saigal et al, 2016).…”

“…Younger age either at the time of transplantation or at the time of the study was a risk factor in eight studies (Askgaard et al, 2016; Choudhary et al, 2022; Donnadieu‐Rigole et al, 2019; Erard‐Poinsot et al, 2016; Lee et al, 2018, 2022; Rice et al, 2013; Zeair et al, 2017), as was a shorter pre‐LT abstinence period (Deruytter et al, 2013; Donnadieu‐Rigole et al, 2019; Egawa, Ueda, et al, 2014; Kitajima et al, 2020; Kruckenberg et al, 2021; Lindenger et al, 2018; Saigal et al, 2016; Yu et al, 2020). History of prior alcohol relapse in the pre‐transplantation period was a significant risk factor in six studies (Deruytter et al, 2013; Deutsch‐Link et al, 2020; Kitajima et al, 2020; Lee et al, 2022; Lindenger et al, 2018), indicating that a higher number of pre‐LT alcohol‐cessation attempts increases the risk for post‐LT alcohol relapse.…”

ACG Clinical Guideline: Alcohol-Associated Liver Disease

“…In the ACCELERATE-AH cohort, where biomarker testing was used to supplement assessment of alcohol relapse, the cumulative incidence of any relapse was 25% (95% CI 18%-34%) at 1-year and 34% (95% CI 25%-44%) at 3year post-LT, with the cumulative incidence of sustained alcohol use being 10% at 1-year (95% CI 6%-18%) and 17% at 3-year (95% CI 10%-27%) post-LT (258). Early onset (,1-year post-LT) and heavy patterns of alcohol use are associated with reduced post-LT survival (258)(259)(260) among patients transplanted for AH.…”

“…Recurrent alcohol-associated cirrhosis occurring in 9% of biopsied patients and 2% of all transplants was responsible for approximately 20% of posttransplant deaths. Early onset (,1-year post-LT) and heavy patterns of alcohol use are associated with reduced post-LT survival (258)(259)(260) among patients transplanted for AH. Policy measures aimed at reducing alcohol use include taxation, reduced availability, and restricted promotion of alcoholcontaining beverages.…”