Recurrence of alcohol ingestion in liver transplantation candidates

Iasi, M; Vieira, Andréa; Añez, C.I.; Trindade, R; Codovani, N.T.B.; Favero, S.S.G.; Soler, Wangles; David, A.I.; D’Capua, A.; Szutan, Luiz Arnaldo; Rolim, Ernani Geraldo

doi:10.1016/s0041-1345(03)00333-6

Cited by 27 publications

(26 citation statements)

References 9 publications

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“…ALD candidates with a short pre‐LTX sobriety need addiction rehabilitation prior to transplantation, as well as strong and sober family supports. In addition, all candidates with ALD should be periodically reassessed on the wait‐list as two studies have reported relapse rates of up to 25% for wait‐listed ALD candidates 21, 22…”

Section: Discussionmentioning

confidence: 99%

Alcohol consumption patterns and predictors of use following liver transplantation for alcoholic liver disease

et al. 2006

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For patients who receive a liver transplant (LTX) for alcoholic liver disease (ALD), investigators are focusing beyond survival to determine specific alcohol use outcomes. Studies suggest the use of alcohol ranges from 8 to 22% for the first posttransplant year with cumulative rates reaching 30 to 40% by 5 years following transplantation. Yet while investigators are interested in determining specific rates of alcohol use and predictors of use, only three studies since 1990 have been prospective. In 1998, we began a prospective study of post-LTX alcohol consumption in ALD recipients using multiple repeated measures of alcohol use. After 5 years of follow-up, we found that 22% had used any alcohol by the first year and 42% had a drink by 5 years. By 5 years, 26% drank at a heavier use (binge) pattern and 20% drank in a frequent pattern. In a univariate model, predictors of alcohol use included pre-transplant length of sobriety, a diagnosis of alcohol dependence, a history of other substance use, and prior alcohol rehabilitation. Liver Transpl 12: 813-820, 2006.

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Section: Discussionmentioning

confidence: 99%

Alcohol consumption patterns and predictors of use following liver transplantation for alcoholic liver disease

et al. 2006

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“…If these patients remain abstinent, their prognosis is superior to that of patients with liver cirrhosis of other etiologies. However, continued alcohol consumption is considered an absolute contraindication for LT. [1][2][3][4] Therefore, the high percentages of relapse cases before LT (19%-50%) 5,6 and after LT (11%-80%) [7][8][9][10][11][12][13][14][15][16][17][18][19][20] pose a serious problem. [21][22][23][24][25] To ensure abstinence by the patient, a strict and systematic investigation is required.…”

Section: See Editorial On Page 1267mentioning

confidence: 99%

Detection of alcohol consumption in patients with alcoholic liver cirrhosis during the evaluation process for liver transplantation

Hempel

Greif-Higer²,

Kaufmann³

et al. 2012

Liver Transpl

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Alcoholic liver cirrhosis (ALC) is a commonly accepted indication for liver transplantation (LT). Any alcohol consumption is considered a contraindication for LT. However, the assessment of abstinence in everyday practice mostly relies on patient self-reporting, which must be considered highly unreliable. After consumption, ethanol is eliminated by alcohol dehydrogenase, with methanol accumulating in the blood. Methanol, which is known to be a sensitive and specific indicator for recent alcohol consumption, has not been used for verifying alcohol consumption in LT assessments yet. Therefore, the purpose of this study was to test the feasibility of using methanol testing to identify recent alcohol consumption in LT candidates during routine and short-notice appointments. We compared methanol and ethanol measurements with self-reported alcohol consumption for 41 patients with ALC during the evaluation process before they were accepted onto the waiting list. In 32 of the 92 blood samples drawn from these 41 patients during the study, a relapse was detected by the methanol test. Both the ethanol test results and the self-reported data were positive in only 3 cases. Thus, the methanol test identified 29 additional cases of alcohol consumption. Furthermore, the methanol test discovered recent alcohol consumption in 5 of 10 transplant patients when both self-reported data and ethanol test results were negative. As a part of blood alcohol analysis, the methanol test is more sensitive than self-reporting and ethanol testing for the detection of recent alcohol consumption. Also, short-notice appointments for blood alcohol analysis reveal more cases of alcohol relapse than routine, long-term appointments. The measurement of methanol as a sensitive screening test for recent alcohol consumption should be implemented both in law and in daily, routine practice.

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“…When alcohol use is reported or detected following liver transplantation, the rate of consumption can vary widely from a single isolated drink (“slip”), to a pattern of repetitive intake of significant amounts of alcohol (“relapse”). When a definition of any alcohol use is applied, the rate of posttransplant alcohol consumption appears to be quite high, approximately 20% (range, 7%‐95%) of patients at a follow‐up of 21 to 83 months following transplantation 15, 21, 26–51. Table 2 presents summary data from 30 published studies that assessed rates of alcohol relapse based on an “any use” definition.…”

Section: Questions Regarding Transplantation For Aldmentioning

confidence: 99%

Liver transplantation for alcoholic liver disease: Current concepts and length of sobriety

2004

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Recurrence of alcohol ingestion in liver transplantation candidates

Cited by 27 publications

References 9 publications

Alcohol consumption patterns and predictors of use following liver transplantation for alcoholic liver disease

Alcohol consumption patterns and predictors of use following liver transplantation for alcoholic liver disease

Detection of alcohol consumption in patients with alcoholic liver cirrhosis during the evaluation process for liver transplantation

Liver transplantation for alcoholic liver disease: Current concepts and length of sobriety

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