Predictors of Relapse to Significant Alcohol Drinking after Liver Transplantation

Abstract

The findings of the present study strongly support a required minimum of six months of abstinence before LT because duration of abstinence was found to be the strongest predictor of recidivism. Female sex, younger age at transplant and psychiatric comorbidities were also associated with relapse to harmful drinking.

Liver Transplantation for Alcohol-Related Liver Disease

“…Several larger studies evaluating rate of relapse and factors predicting relapse after liver transplantation are shown in Table 1, the relapse rate varies from 16% to 42% and harmful relapse rate varies from 10% to 18%. 11,[23][24][25][26][27][28][29][30][31][32][33] Various factors found to predictive of post-transplant alcohol relapse are shown in Table 2. Following variables have been shown to be associated with risk of post-transplant alcohol relapse: absence of structured management program pretransplant, length of pretransplant sobriety, alcohol or other substance dependence, prior alcohol rehabilitation, poor social support/lack of partner, poor psychosomatic prognosis or psychiatric comorbidity, female sex, patients' nonacceptance of having an alcohol problem before LT, continued alcohol use after liver disease diagnosis, low motivation for alcohol treatment, and presence of a first-degree relative with alcohol abuse in family.…”

“…Following variables have been shown to be associated with risk of post-transplant alcohol relapse: absence of structured management program pretransplant, length of pretransplant sobriety, alcohol or other substance dependence, prior alcohol rehabilitation, poor social support/lack of partner, poor psychosomatic prognosis or psychiatric comorbidity, female sex, patients' nonacceptance of having an alcohol problem before LT, continued alcohol use after liver disease diagnosis, low motivation for alcohol treatment, and presence of a first-degree relative with alcohol abuse in family. 11,[23][24][25][26][27][28][29][30][31][32][33] Pretransplant sobriety predicting absence of alcohol relapse after liver transplant is not a universal finding. 11,15,[23][24][25][26][27][28][29][30][31][32][33] Scoring systems also have been proposed to predict post-transplant alcohol relapse.…”

“…11,[23][24][25][26][27][28][29][30][31][32][33] Pretransplant sobriety predicting absence of alcohol relapse after liver transplant is not a universal finding. 11,15,[23][24][25][26][27][28][29][30][31][32][33] Scoring systems also have been proposed to predict post-transplant alcohol relapse. In a study of 118 patients by Rodrigue et al, 31 the authors advised a scoring system (Alcohol Relapse Risk Assessment) to predict risk of relapse.…”

“…Several larger studies evaluating rate of relapse and factors predicting relapse after liver transplantation are shown in Table 1, the relapse rate varies from 16% to 42% and harmful relapse rate varies from 10% to 18%. 11,[23][24][25][26][27][28][29][30][31][32][33] Various factors found to predictive of post-transplant alcohol relapse are shown in …”

The Role of Liver Transplantation in theTreatment of Alcoholic Liver Disease

“…In addition to the studies supporting that the length of sobriety is a strong predictor of recidivism, there are others reporting that patients with a DSM-IV diagnosis of abuse had a lower relapse probability than those with alcohol dependence (DiMartini et al, 2006;Karim et al, 2010). DiMartini et al showed that variables such as alcohol dependence, short length of sobriety, family history of alcohol consumption and the use of other substances identified patients with a major risk of relapse (DiMartini et al, 2010).…”