Recidivism in Liver Transplant Recipients for Alcohol-related Liver Disease

Choudhary, Narendra S.; Saraf, Neeraj; Mehrotra, Saurabh; Saigal, Sanjiv; Soin, Arvinder S.

doi:10.1016/j.jceh.2020.08.011

Cited by 9 publications

(5 citation statements)

References 63 publications

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“…In addition, occasional slips were not accounted for in this study. Other limitations include the definition of significant alcohol intake as there is no universally accepted definition and various studies have considered different values as significant, 24 and there are no data on nicotine use before or after LT. In addition, diagnosis of recidivism was based on history and not by biochemical tests; thus, it is possible that we have missed some patients with significant alcohol intake who had normal graft functions.…”

Section: Discussionmentioning

confidence: 99%

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

Choudhary

Saraf

Dhampalwar

et al. 2022

Journal of Clinical and Experimental Hepatology

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Section: Discussionmentioning

confidence: 99%

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

Choudhary

Saraf

Dhampalwar

et al. 2022

Journal of Clinical and Experimental Hepatology

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“… 7 , 23 Long‐term studies have demonstrated that occasional or moderately heavy drinking does not impact graft function or patient survival. However, significant alcohol intake is associated with poor survival after LT. 24 , 25 , 26 An estimated 10%–20% of patients who return to alcohol use after LT have a harmful drinking pattern and it has been shown that severe alcoholic relapse usually occurs in the early years after LT and is responsible for severe graft injury in a very few years with a cumulative risk of cirrhosis of 15% at 3 years, 32% at 5 years, and 54% at 10 years after severe alcoholic relapse. 27 Moreover, recurrence of alcohol‐related cirrhosis is associated with a high risk of liver decompensation and a poor prognosis, with a survival rate of 37.8% at 5 years after diagnosis of cirrhosis.…”

Section: Definition Detection and Consequences Of Return To Alcohol D...mentioning

confidence: 99%

Workup and management of liver transplantation in alcohol‐related liver disease

Germani,

Degré,

Moreno

et al. 2024

UEG Journal

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Alcohol‐related liver disease (ALD) represents the most common indication for liver transplantation (LT) worldwide. Outcomes of LT for ALD are comparable with those of LT for other etiologies; however, ALD is still considered a controversial indication for LT, mainly because it is considered a self‐inflicted disease with a high risk of return to alcohol use after LT. Pre‐LT evaluation criteria have changed over time, with a progressive re‐evaluation of the required pre‐transplant duration of abstinence. Despite the fact that some transplant programs still require 6 months of abstinence in order to consider a patient suitable for LT, there is increasing evidence that a pre‐transplant abstinence period of <6 months can be considered for well‐selected patients. Early LT for severe alcohol‐related hepatitis that has not responded to medical therapy has been shown to be an effective therapeutic option with high survival benefit when performed within strict and well‐recognized criteria. However, high variability in LT access exists for these patients due to the presence of social and medical stigma. A psycho‐social assessment, together with an evaluation by an addiction specialist, should be mandatory in patients with ALD who are potential candidates for LT in order to assess the risk of post‐transplant return to alcohol use and to ensure good long‐term outcomes. Finally, before LT, attention should be paid to the presence of other potential comorbidities (i.e., cardiovascular and neurological diseases), which could represent a potential contraindication to LT. Similarly, after LT, patients should be adequately monitored for the development of cardiovascular events and screened for “de novo” tumors, although standardized protocols for this monitoring do not exist at this time.

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Section: Introductionmentioning

confidence: 99%

“…Alcohol relapse after LT has been reported in 7–95% of individuals, with harmful drinking reported to be between 10 and 26% [ 4 , 5 , 6 , 7 , 8 ]. This broad range is mainly due to the lack of standardized definitions for alcohol consumption post-LT [ 4 , 5 , 6 ]. There are known risk factors associated with alcohol relapse after LT, being the most consistently proven younger age, active smoking, poor social support, unemployment, and a family environment with alcohol use [ 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 ].…”

Section: Introductionmentioning

confidence: 99%

“…Accordingly, we hypothesized that alcohol consumption following LT would be frequent but non-severe in our cohort [ 1 , 4 , 5 , 6 ]. Therefore, the objectives of our study were the following: (1) to assess the prevalence of alcohol use post-LT based on the AUDIT score in a Portuguese sample of LT recipients and (2) to try to further characterize patients that more likely drank alcohol following LT.…”

Section: Introductionmentioning

confidence: 99%

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Alcohol Consumption Post-Liver Transplantation: A Cross-Sectional Study

Rebelo¹,

Félix²,

Cardoso³

et al. 2022

GE Port J Gastroenterol

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Background: Listing patients with alcohol-associated liver disease (ALD) for liver transplant (LT) remains challenging especially due to the risk of alcohol resumption post-LT. We aimed to evaluate post-LT alcohol consumption at a Portuguese transplant center. Methods: We conducted a cross-sectional study including LT recipients from 2019 at Curry Cabral Hospital, Lisbon, Portugal. A pretested survey and a validated Portuguese translation of the Alcohol Use Disorder Identification Test (AUDIT) were applied via a telephone call. Alcohol consumption was defined by patients’ self-reports or a positive AUDIT. Results: In 2019, 122 patients underwent LT, and 99 patients answered the survey (June 2021). The mean (SD) age was 57 (10) years, 70 patients (70.7%) were males, and 49 (49.5%) underwent ALD-related LT. During a median (IQR) follow-up of 24 (20–26) months post-index LT, 22 (22.2%) recipients consumed any amount of alcohol: 14 had a drink monthly or less and 8 drank 2–4 times/month. On drinking days, 18 patients usually consumed 1–2 drinks and the remainder no more than 3–4 drinks. One patient reported having drunk ≥6 drinks on one occasion. All post-LT drinking recipients were considered low risk (score <8) as per the AUDIT score (median [IQR] of 1 [1–2]). No patient reported alcohol-related problems, whether self-inflicted or toward others. Drinking recipients were younger (53 vs. 59 years, p = 0.020), had more non-ALD-related LT (72.7 vs. 44.2%, p = 0.018) and active smoking (31.8 vs. 10.4%, p = 0.037) than abstinent ones. Conclusion: In our cohort, about a quarter of LT recipients consumed alcohol early posttransplant, all with a low-risk pattern according to the AUDIT score.

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Recidivism in Liver Transplant Recipients for Alcohol-related Liver Disease

Cited by 9 publications

References 63 publications

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

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

Workup and management of liver transplantation in alcohol‐related liver disease

Alcohol Consumption Post-Liver Transplantation: A Cross-Sectional Study

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