Tobacco use before and after liver transplantation: A single center survey and implications for clinical practice and research

Ehlers, Shawna L.; Rodrigue, James R.; Widows, Michelle R.; Reed, Alan; Nelson, David R.

doi:10.1002/lt.20087

Cited by 73 publications

(43 citation statements)

References 22 publications

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“…A higher incidence of lung cancer post-LTx with poorer prognosis has been reported by Jiménez et al 44 and others. 41,42,45 In contrast, Haagsma and others did not find any cases of oropharyngeal cancer in their series, 20,24,27,[46][47][48] and only 1 case of oropharyngeal and lung cancer was observed in the present study by Åberg and coworkers, 36 which included 54 cases of alcoholic cirrhosis.…”

Section: Brief Description Of the Differences In The Incidence Of Varcontrasting

confidence: 73%

“…12,40 In 1 study, more than 50% of patients transplanted for alcohol-related diseases had a history of smoking. 41 DiMartini and coworkers 42 from the University of Pittsburgh reported a prospective study confirming the underreporting of smoking. An epidemiological study of 1.2 million US adults with alcohol consumption revealed a significantly higher risk for oral, esophageal, pharyngeal, laryngeal, and liver cancers in middle-aged and elderly populations.…”

Section: Brief Description Of the Differences In The Incidence Of Varmentioning

confidence: 92%

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Incidence of de novo cancer and lymphoproliferative disorders after liver transplantation in relation to age and duration of follow-up

2008

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Section: Brief Description Of the Differences In The Incidence Of Varcontrasting

confidence: 73%

Section: Brief Description Of the Differences In The Incidence Of Varmentioning

confidence: 92%

Incidence of de novo cancer and lymphoproliferative disorders after liver transplantation in relation to age and duration of follow-up

2008

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“…58 Smoking is common in ALD and patients tend to smoke after transplant also. [59][60][61] DiMartini et al showed that 40% of ALD recipients resume smoking, generally in early posttransplantation period and they tend to have tendency to increase consumption over time and to become tobacco dependent. Active smoking after transplantation in ALD has been shown to be an independent predictor of long-term morbidity and mortality, either from cardiovascular complications or from de novo neoplasms.…”

Section: Risk Of Malignancy After Liver Transplantmentioning

confidence: 99%

Liver Transplantation for Alcohol-Related Liver Disease

Choudhary

Kumar

Saigal

et al. 2016

Journal of Clinical and Experimental Hepatology

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Alcoholic liver disease (ALD) is a common indication for liver transplantation. It is a much debated indication for deceased donor liver transplantation due to organ shortage and potential of alcohol relapse after liver transplantation. A six-month abstinence before liver transplantation is required at most centers to decrease chances of alcohol relapse after liver transplantation. However, this rule is not relevant for patients with severe alcoholic hepatitis or severely decompensated patients who are unlikely to survive till 6 months. Long-term care of these patients after liver transplantation includes assessment of relapse, smoking, and surveillance of de novo malignancies. Current review discusses role of abstinence, factors affecting alcohol relapse, liver transplantation for alcoholic hepatitis, role of living donor liver transplantation, and long-term care of ALD patients who undergo liver transplantation. ( J CLIN EXP HEPATOL 2016;6:47-53) A lcoholic liver disease (ALD) is common indication for liver transplantation worldwide, 1,2 and is a common cause of decompensated cirrhosis and acute-on-chronic liver failure in India as well. 3,4 ALD has good outcome after liver transplantation that is comparable or better than other etiologies of liver transplantation. Recent European liver transplant registry data showed 73% 5-year and a 59% 10-year survival rate for ALD. 2 However, survival is lower in recipients who relapse to harmful pattern of drinking as noted in a systemic review of 13 studies by Rustad et al. 5 Liver transplantation for ALD leads to improvement in quality of life and employment rates. 6,7 During selection of these patients for liver transplantation, it is important to identify other alcohol-related problems like cardiomyopathy, chronic pancreatitis, skeletal muscle wasting, and neurotoxicities that may preclude or impair outcome of liver transplantation. 8 Patients who have lack of social support, are active smokers, and have psychiatric disorders or alcohol dependence should be listed only with reservations. 9 Smoking worsens the outcome of alcohol-related liver disease 10 and active smoking at the time of liver transplantation has been shown to be associated with post-transplant recidivism also. 11 PREDICTORS OF RELAPSEWhile liver transplantation improves functions of liver and cures complications of portal hypertension, it does not affect alcoholism and recipients may relapse again, sometimes to harmful levels of drinking, and pretransplant sobriety does not confirm sobriety after liver transplant. [12][13][14] Relapse may be in the form of occasional slips or harmful drinking pattern for a prolonged period; the later affects graft and patient survival. 5,11 Initially, 6-month abstinence was considered as a requirement before allocating organ to patients with ALD; however, it was based on poor quality small data. 15 The 6-month rule serves 2 purposes; it provides patient time to demonstrate a certain period of abstinence and patient may recover on medical management, and thus preempt...

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“…[1317] As in the general population, smoking is the main risk factor for development of obstructive airway disease. In a study by Ehlers et al ., smoking has been shown to affect the postoperative outcome adversely in patients who underwent LT.[18] As a result, it is our belief that specific attention should be paid to those patients who smoke in the pretransplant pulmonary evaluation. Coexisting restrictive type of airway disease is also common in patients with advanced liver disease.…”

Section: Hepatopulmonary Syndrome and Gas Exchange Abnormalitiesmentioning

confidence: 99%

Evaluation of liver transplant candidates: A pulmonary perspective

Bozbas¹,

Eyüboğlu²

2011

Ann Thorac Med

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Chronic liver disease is one of the leading causes of mortality and morbidity in the worldwide adult population. Liver transplant is the gold standard therapy for end-stage liver disease and many patients are on the waiting list for a transplant. A variety of pulmonary disorders are encountered in cirrhotic patients. Pleura, lung parenchyma, and pulmonary vasculature may be affected in these patients. Hypoxemia is relatively common and can be asymptomatic. Hepatopulmonary syndrome should be investigated in hypoxic cirrhotic patients. Gas exchange abnormalities are common and are generally correlated with the severity of liver disease. Both obstructive and restrictive types of airway disease can be present. Abnormal diffusion capacity is the most frequently observed pulmonary function disorder in patients with cirrhosis. Hepatic hydrothorax is another finding which is usually seen in conjunction with, but occasionally without ascites. Portopulmonary hypertension is a complication of long standing liver dysfunction and when severe, is accepted as a containdication to liver transplant. Since respiratory disorders are common and have significant impact on postoperative outcome in patients undergoing liver transplant, a careful preoperative pulmonary assessment is important.

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Tobacco use before and after liver transplantation: A single center survey and implications for clinical practice and research

Cited by 73 publications

References 22 publications

Incidence of de novo cancer and lymphoproliferative disorders after liver transplantation in relation to age and duration of follow-up

Incidence of de novo cancer and lymphoproliferative disorders after liver transplantation in relation to age and duration of follow-up

Liver Transplantation for Alcohol-Related Liver Disease

Evaluation of liver transplant candidates: A pulmonary perspective

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