Published online Feb 7, 2017. doi: 10.3748/wjg.v23.i5.869
Peer-review started: September 18, 2016
First decision: October 20, 2016
Revised: November 6, 2016
Accepted: December 8, 2016
Article in press: December 8, 2016
Published online: February 7, 2017
Processing time: 127 Days and 16.4 Hours
To investigate factors, including psychosocial factors, associated with alcoholic use relapse after liver transplantation (LT) for alcoholic liver disease (ALD).
The clinical records of 102 patients with ALD who were referred to Nagoya University Hospital for LT between May 2003 and March 2015 were retrospectively evaluated. History of alcohol intake was obtained from their clinical records and scored according to the High-Risk Alcoholism Relapse scale, which includes duration of heavy drinking, types and amount of alcohol usually consumed, and previous inpatient treatment history for alcoholism. All patients were assessed for eligibility for LT according to comprehensive criteria, including Child-Pugh score, Model for End-Stage Liver Disease score, and psychosocial criteria.
Of the 102 patients with ALD referred for LT, seven (6.9%) underwent LT. One (14.3%) of these seven patients returned to heavy drinking, but that patient was able to successfully quit drinking following an immediate intervention, consisting of psychotherapeutic education and supportive psychotherapy, by a psychiatrist. A comparison between the transplantation/registration (T/R) group, consisting of the seven patients who underwent LT and 10 patients listed for deceased donor LT, and 50 patients who did not undergo LT and were not listed for deceased donor LT (non-T/R group), showed statistically significant differences in duration of abstinence period (P < 0.01), duration of heavy drinking (P < 0.05), adherence to medical treatment (P < 0.01), and declaration of abstinence (P < 0.05).
Patients with ALD referred for LT require comprehensive evaluation, including evaluation of psychosocial criteria, to prevent alcoholic recidivism.
Core tip: Although alcoholic liver disease (ALD) is the second most common indication for liver transplantation (LT), post-transplant relapse of alcohol use can have a negative impact on patient outcomes. It is therefore important to preoperatively assess the risk of post-transplant alcohol use. To date, however, psychosocial evaluation criteria of LT for ALD have not been established, indicating a real need for useful criteria to assess the risks of post-transplant alcohol use. This study describes a set of psychosocial evaluation criteria that may be useful in assessing the risk of relapse in patients who undergo LT for ALD.