18 June 2019 : Original article
Alcohol Use Relapse Following Liver Transplantation for Alcoholic Liver Disease
Lubomir Skladany1ADEF, Svetlana Adamcova Selcanova1BDEF*, Tomas Koller2CDEDOI: 10.12659/AOT.914690
Ann Transplant 2019; 24:359-366
Abstract
BACKGROUND: Alcohol use disorders affect 10% of the European population. Alcohol-related liver disease (ALD) is the most common indication for liver transplantation in Slovakia. The aim of this study was to determine the proportion of patients with ALD who received a liver transplant who had alcohol relapsed, and the risk factors for alcohol relapse, as well as to compare clinical outcomes according to relapse.
MATERIAL AND METHODS: A retrospective study of consecutive patients with ALD, who underwent liver transplantation in a single transplant center between May 2008 and December 2017. We included adult patients who received a liver transplant due to ALD and excluded those who died <1 month after liver transplantation. We recorded demographic and clinical characteristics, graft injury, and overall mortality and compared them between relapsers and abstainers.
RESULTS: During the study period, we reviewed 196 cases of liver transplantation in 191 patients. We excluded 87 patients for non-ALD etiology and 15 patients by predefined criteria. The final analysis was carried out in 89 patients, mean aged 55 years; 24.7% were female. We diagnosed relapse in 23 patients (26%) with harmful drinking in 52% and occasional drinking in 48% of relapsers. The independent risk factors associated with relapse were: smoking (OR=5.92, P=0.006), loss of social status (OR=7.61, P=0.002), and time after liver transplantation (OR=1.0008, P=0.015). Graft injury was more frequent in relapsers with 2 independent risk factors: occasional drinking (OR=12.7, P=0.0005), and harmful drinking (OR=36.6, P<0.0001); overall survival was unaffected.
CONCLUSIONS: We found relapse to alcohol drinking in 26% of patients who received a liver transplant for ALD. Risk factors associated with alcohol drinking relapse were time, cigarette smoking, and loss of social status. Graft injury was more frequent in relapsers, but mortality was similar between relapsers and non-relapsers.
Keywords: Liver Cirrhosis, Alcoholic, Liver Diseases, Alcoholic, Liver Transplantation, Alcohol-Induced Disorders, Alcoholism, Graft Survival, Postoperative Period, Recurrence, Risk Factors
In Press
Original article
CD146⁺ Endothelial Cells Facilitate Renal Interstitial Fibrosis Through Endothelial-to-Mesenchymal TransitionAnn Transplant In Press; DOI: 10.12659/AOT.945917
Original article
Effect of Medical Accessibility on Long-Term Survival in Liver TransplantationAnn Transplant In Press; DOI: 10.12659/AOT.944839
Most Viewed Current Articles
05 Apr 2022 : Original article 13,217
Impact of Statins on Hepatocellular Carcinoma Recurrence After Living-Donor Liver TransplantationDOI :10.12659/AOT.935604
Ann Transplant 2022; 27:e935604
22 Nov 2022 : Original article 10,665
Long-Term Effects of Everolimus-Facilitated Tacrolimus Reduction in Living-Donor Liver Transplant Recipient...DOI :10.12659/AOT.937988
Ann Transplant 2022; 27:e937988
12 Jan 2022 : Original article 9,806
Risk Factors for Developing BK Virus-Associated Nephropathy: A Single-Center Retrospective Cohort Study of ...DOI :10.12659/AOT.934738
Ann Transplant 2022; 27:e934738
15 Mar 2022 : Case report 7,520
Combined Liver, Pancreas-Duodenum, and Kidney Transplantation for Patients with Hepatitis B Cirrhosis, Urem...DOI :10.12659/AOT.935860
Ann Transplant 2022; 27:e935860