Liver transplantation in alcoholic patients: Impact of an alcohol addiction unit within a liver transplant center

Giovanni Addolorato; Antonio Mirijello; Lorenzo Leggio; Anna Ferrulli; Cristina D'Angelo; Gabriele Vassallo; Anthony Cossari; Giovanni Battista Gasbarrini; Raffaele Landolfi; Salvatore Agnes; Antonio Gasbarrini; Valeria Abbate; Ludovico Abenavoli; Massimo Antonelli; Brigida Eleonora Annicchiarico; Alfonso Wolfango Avolio; Marco Biolato; Chiara Campanale; Esmeralda Capristo; Fabio Caputo; Francesco Maria Caputo; Valentina Cesario; Marco Castagneto; Nicoletta Dematthaeis; Chantal Favale; Daniele Ferrarese; Matteo Garcovich; Francesco Frongillo; Antonio Grieco; Noemi Malandrino; Luca Miele; Alessandro Milani; Domenico Arturo Nesci; Erida Nure; Giorgio Pelecca; Gilda Pepe; Paola Pietrogiacomi; Fabrizio Pizzolante; Maurizio Pompili; Francesca Romana Ponziani; Gian Ludovico Rapaccini; Laura Riccardi; Emanuele Rinninella; Michele C. Santoro; Gabriele Sganga; Massimo Siciliano; Vittoria Vero; Luisa Vonghia

doi:10.1111/acer.12117

Liver transplantation in alcoholic patients: Impact of an alcohol addiction unit within a liver transplant center

Giovanni Addolorato, Antonio Mirijello, Lorenzo Leggio, Anna Ferrulli, Cristina D'Angelo, Gabriele Vassallo, Anthony Cossari, Giovanni Battista Gasbarrini, Raffaele Landolfi, Salvatore Agnes, Antonio Gasbarrini, Valeria Abbate, Ludovico Abenavoli, Massimo Antonelli, Brigida Eleonora Annicchiarico, Alfonso Wolfango Avolio, Marco Biolato, Chiara Campanale, Esmeralda Capristo, Fabio CaputoFrancesco Maria Caputo, Valentina Cesario, Marco Castagneto, Nicoletta Dematthaeis, Chantal Favale, Daniele Ferrarese, Matteo Garcovich, Francesco Frongillo, Antonio Grieco, Noemi Malandrino, Luca Miele, Alessandro Milani, Domenico Arturo Nesci, Erida Nure, Giorgio Pelecca, Gilda Pepe, Paola Pietrogiacomi, Fabrizio Pizzolante, Maurizio Pompili, Francesca Romana Ponziani, Gian Ludovico Rapaccini, Laura Riccardi, Emanuele Rinninella, Michele C. Santoro, Gabriele Sganga, Massimo Siciliano, Vittoria Vero, Luisa Vonghia

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Abstract

Background: Many concerns about liver transplantation in alcoholic patients are related to the risk of alcohol recidivism. Starting from 2002, an Alcohol Addiction Unit (AAU) was formed within the liver transplant center for the management of alcoholic patients affected by end-stage liver disease and included in the waiting list for transplantation. We evaluated retrospectively the impact of the AAU on alcohol recidivism after transplantation. The relationship between alcohol recidivism and the duration of alcohol abstinence before transplant was evaluated as well. Methods: Between 1995 and 2010, 92 cirrhotic alcoholic patients underwent liver transplantation. Clinical evaluation and management of alcohol use in these patients was provided by psychiatrists with expertise in addiction medicine not affiliated to the liver transplant center before 2002 (n = 37; group A), or by the clinical staff of the AAU within the liver transplant center starting from 2002 (n = 55; group B). Results: Group B, as compared with group A, showed a significantly lower prevalence of alcohol recidivism (16.4 vs. 35.1%; p = 0.038) and a significantly lower mortality (14.5 vs. 37.8%; p = 0.01). Furthermore, an analysis of group B patients with either ≥6 or <6 months of alcohol abstinence before transplantation showed no difference in the rate of alcohol recidivism (21.1 vs. 15.4%; p = ns). Conclusions: The presence of an AAU within a liver transplant center reduces the risk of alcohol recidivism after transplantation. A pretransplant abstinence period <6 months might be considered, at least in selected patients managed by an AAU. © 2013 by the Research Society on Alcoholism.

Original language	English
Pages (from-to)	1601-1608
Number of pages	8
Journal	ALCOHOLISM-CLINICAL AND EXPERIMENTAL RESEARCH
Volume	37
DOIs	https://doi.org/10.1111/acer.12117
Publication status	Published - 2013

Keywords

Adult
Aged
Alcohol Abstinence
Alcohol Addiction Unit
Alcohol Dependence
Alcohol Recidivism
Alcoholics
Alcoholism
Baclofen
Female
Follow-Up Studies
Humans
Liver Transplantation
Male
Middle Aged
Orthotopic Liver Transplantation
Retrospective Studies
Substance Abuse Treatment Centers
Treatment Outcome

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1111/acer.12117

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Addolorato, G., Mirijello, A., Leggio, L., Ferrulli, A., D'Angelo, C., Vassallo, G., Cossari, A., Gasbarrini, G. B., Landolfi, R., Agnes, S., Gasbarrini, A., Abbate, V., Abenavoli, L., Antonelli, M., Annicchiarico, B. E., Avolio, A. W., Biolato, M., Campanale, C., Capristo, E., ... Vonghia, L. (2013). Liver transplantation in alcoholic patients: Impact of an alcohol addiction unit within a liver transplant center. ALCOHOLISM-CLINICAL AND EXPERIMENTAL RESEARCH, 37, 1601-1608. https://doi.org/10.1111/acer.12117

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title = "Liver transplantation in alcoholic patients: Impact of an alcohol addiction unit within a liver transplant center",

abstract = "Background: Many concerns about liver transplantation in alcoholic patients are related to the risk of alcohol recidivism. Starting from 2002, an Alcohol Addiction Unit (AAU) was formed within the liver transplant center for the management of alcoholic patients affected by end-stage liver disease and included in the waiting list for transplantation. We evaluated retrospectively the impact of the AAU on alcohol recidivism after transplantation. The relationship between alcohol recidivism and the duration of alcohol abstinence before transplant was evaluated as well. Methods: Between 1995 and 2010, 92 cirrhotic alcoholic patients underwent liver transplantation. Clinical evaluation and management of alcohol use in these patients was provided by psychiatrists with expertise in addiction medicine not affiliated to the liver transplant center before 2002 (n = 37; group A), or by the clinical staff of the AAU within the liver transplant center starting from 2002 (n = 55; group B). Results: Group B, as compared with group A, showed a significantly lower prevalence of alcohol recidivism (16.4 vs. 35.1%; p = 0.038) and a significantly lower mortality (14.5 vs. 37.8%; p = 0.01). Furthermore, an analysis of group B patients with either ≥6 or <6 months of alcohol abstinence before transplantation showed no difference in the rate of alcohol recidivism (21.1 vs. 15.4%; p = ns). Conclusions: The presence of an AAU within a liver transplant center reduces the risk of alcohol recidivism after transplantation. A pretransplant abstinence period <6 months might be considered, at least in selected patients managed by an AAU. {\textcopyright} 2013 by the Research Society on Alcoholism.",

keywords = "Adult, Aged, Alcohol Abstinence, Alcohol Addiction Unit, Alcohol Dependence, Alcohol Recidivism, Alcoholics, Alcoholism, Baclofen, Female, Follow-Up Studies, Humans, Liver Transplantation, Male, Middle Aged, Orthotopic Liver Transplantation, Retrospective Studies, Substance Abuse Treatment Centers, Treatment Outcome, Adult, Aged, Alcohol Abstinence, Alcohol Addiction Unit, Alcohol Dependence, Alcohol Recidivism, Alcoholics, Alcoholism, Baclofen, Female, Follow-Up Studies, Humans, Liver Transplantation, Male, Middle Aged, Orthotopic Liver Transplantation, Retrospective Studies, Substance Abuse Treatment Centers, Treatment Outcome",

author = "Giovanni Addolorato and Antonio Mirijello and Lorenzo Leggio and Anna Ferrulli and Cristina D'Angelo and Gabriele Vassallo and Anthony Cossari and Gasbarrini, {Giovanni Battista} and Raffaele Landolfi and Salvatore Agnes and Antonio Gasbarrini and Valeria Abbate and Ludovico Abenavoli and Massimo Antonelli and Annicchiarico, {Brigida Eleonora} and Avolio, {Alfonso Wolfango} and Marco Biolato and Chiara Campanale and Esmeralda Capristo and Fabio Caputo and Caputo, {Francesco Maria} and Valentina Cesario and Marco Castagneto and Nicoletta Dematthaeis and Chantal Favale and Daniele Ferrarese and Matteo Garcovich and Francesco Frongillo and Antonio Grieco and Noemi Malandrino and Luca Miele and Alessandro Milani and Nesci, {Domenico Arturo} and Erida Nure and Giorgio Pelecca and Gilda Pepe and Paola Pietrogiacomi and Fabrizio Pizzolante and Maurizio Pompili and {Romana Ponziani}, Francesca and Rapaccini, {Gian Ludovico} and Laura Riccardi and Emanuele Rinninella and Santoro, {Michele C.} and Gabriele Sganga and Massimo Siciliano and Vittoria Vero and Luisa Vonghia",

year = "2013",

doi = "10.1111/acer.12117",

language = "English",

volume = "37",

pages = "1601--1608",

journal = "ALCOHOLISM-CLINICAL AND EXPERIMENTAL RESEARCH",

issn = "0145-6008",

publisher = "Lippincott, Williams & Wilkins:530 Walnut Street:Philadelphia, PA 19106:(800)638-3030, (301)223-2300, EMAIL: [email protected], INTERNET: http://www.lww.com, Fax: (301)223-2320, (301)223-2320",

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Addolorato, G, Mirijello, A, Leggio, L, Ferrulli, A, D'Angelo, C, Vassallo, G, Cossari, A, Gasbarrini, GB, Landolfi, R, Agnes, S , Gasbarrini, A, Abbate, V, Abenavoli, L, Antonelli, M, Annicchiarico, BE, Avolio, AW, Biolato, M, Campanale, C, Capristo, E, Caputo, F, Caputo, FM, Cesario, V, Castagneto, M, Dematthaeis, N, Favale, C, Ferrarese, D, Garcovich, M, Frongillo, F, Grieco, A, Malandrino, N, Miele, L, Milani, A, Nesci, DA, Nure, E, Pelecca, G, Pepe, G, Pietrogiacomi, P, Pizzolante, F, Pompili, M, Romana Ponziani, F, Rapaccini, GL, Riccardi, L, Rinninella, E, Santoro, MC, Sganga, G, Siciliano, M, Vero, V & Vonghia, L 2013, 'Liver transplantation in alcoholic patients: Impact of an alcohol addiction unit within a liver transplant center', ALCOHOLISM-CLINICAL AND EXPERIMENTAL RESEARCH, vol. 37, pp. 1601-1608. https://doi.org/10.1111/acer.12117

TY - JOUR

T1 - Liver transplantation in alcoholic patients: Impact of an alcohol addiction unit within a liver transplant center

AU - Addolorato, Giovanni

AU - Mirijello, Antonio

AU - Leggio, Lorenzo

AU - Ferrulli, Anna

AU - D'Angelo, Cristina

AU - Vassallo, Gabriele

AU - Cossari, Anthony

AU - Gasbarrini, Giovanni Battista

AU - Landolfi, Raffaele

AU - Agnes, Salvatore

AU - Gasbarrini, Antonio

AU - Abbate, Valeria

AU - Abenavoli, Ludovico

AU - Antonelli, Massimo

AU - Annicchiarico, Brigida Eleonora

AU - Avolio, Alfonso Wolfango

AU - Biolato, Marco

AU - Campanale, Chiara

AU - Capristo, Esmeralda

AU - Caputo, Fabio

AU - Caputo, Francesco Maria

AU - Cesario, Valentina

AU - Castagneto, Marco

AU - Dematthaeis, Nicoletta

AU - Favale, Chantal

AU - Ferrarese, Daniele

AU - Garcovich, Matteo

AU - Frongillo, Francesco

AU - Grieco, Antonio

AU - Malandrino, Noemi

AU - Miele, Luca

AU - Milani, Alessandro

AU - Nesci, Domenico Arturo

AU - Nure, Erida

AU - Pelecca, Giorgio

AU - Pepe, Gilda

AU - Pietrogiacomi, Paola

AU - Pizzolante, Fabrizio

AU - Pompili, Maurizio

AU - Romana Ponziani, Francesca

AU - Rapaccini, Gian Ludovico

AU - Riccardi, Laura

AU - Rinninella, Emanuele

AU - Santoro, Michele C.

AU - Sganga, Gabriele

AU - Siciliano, Massimo

AU - Vero, Vittoria

AU - Vonghia, Luisa

PY - 2013

Y1 - 2013

N2 - Background: Many concerns about liver transplantation in alcoholic patients are related to the risk of alcohol recidivism. Starting from 2002, an Alcohol Addiction Unit (AAU) was formed within the liver transplant center for the management of alcoholic patients affected by end-stage liver disease and included in the waiting list for transplantation. We evaluated retrospectively the impact of the AAU on alcohol recidivism after transplantation. The relationship between alcohol recidivism and the duration of alcohol abstinence before transplant was evaluated as well. Methods: Between 1995 and 2010, 92 cirrhotic alcoholic patients underwent liver transplantation. Clinical evaluation and management of alcohol use in these patients was provided by psychiatrists with expertise in addiction medicine not affiliated to the liver transplant center before 2002 (n = 37; group A), or by the clinical staff of the AAU within the liver transplant center starting from 2002 (n = 55; group B). Results: Group B, as compared with group A, showed a significantly lower prevalence of alcohol recidivism (16.4 vs. 35.1%; p = 0.038) and a significantly lower mortality (14.5 vs. 37.8%; p = 0.01). Furthermore, an analysis of group B patients with either ≥6 or <6 months of alcohol abstinence before transplantation showed no difference in the rate of alcohol recidivism (21.1 vs. 15.4%; p = ns). Conclusions: The presence of an AAU within a liver transplant center reduces the risk of alcohol recidivism after transplantation. A pretransplant abstinence period <6 months might be considered, at least in selected patients managed by an AAU. © 2013 by the Research Society on Alcoholism.

AB - Background: Many concerns about liver transplantation in alcoholic patients are related to the risk of alcohol recidivism. Starting from 2002, an Alcohol Addiction Unit (AAU) was formed within the liver transplant center for the management of alcoholic patients affected by end-stage liver disease and included in the waiting list for transplantation. We evaluated retrospectively the impact of the AAU on alcohol recidivism after transplantation. The relationship between alcohol recidivism and the duration of alcohol abstinence before transplant was evaluated as well. Methods: Between 1995 and 2010, 92 cirrhotic alcoholic patients underwent liver transplantation. Clinical evaluation and management of alcohol use in these patients was provided by psychiatrists with expertise in addiction medicine not affiliated to the liver transplant center before 2002 (n = 37; group A), or by the clinical staff of the AAU within the liver transplant center starting from 2002 (n = 55; group B). Results: Group B, as compared with group A, showed a significantly lower prevalence of alcohol recidivism (16.4 vs. 35.1%; p = 0.038) and a significantly lower mortality (14.5 vs. 37.8%; p = 0.01). Furthermore, an analysis of group B patients with either ≥6 or <6 months of alcohol abstinence before transplantation showed no difference in the rate of alcohol recidivism (21.1 vs. 15.4%; p = ns). Conclusions: The presence of an AAU within a liver transplant center reduces the risk of alcohol recidivism after transplantation. A pretransplant abstinence period <6 months might be considered, at least in selected patients managed by an AAU. © 2013 by the Research Society on Alcoholism.

KW - Adult

KW - Aged

KW - Alcohol Abstinence

KW - Alcohol Addiction Unit

KW - Alcohol Dependence

KW - Alcohol Recidivism

KW - Alcoholics

KW - Alcoholism

KW - Baclofen

KW - Female

KW - Follow-Up Studies

KW - Humans

KW - Liver Transplantation

KW - Male

KW - Middle Aged

KW - Orthotopic Liver Transplantation

KW - Retrospective Studies

KW - Substance Abuse Treatment Centers

KW - Treatment Outcome

KW - Adult

KW - Aged

KW - Alcohol Abstinence

KW - Alcohol Addiction Unit

KW - Alcohol Dependence

KW - Alcohol Recidivism

KW - Alcoholics

KW - Alcoholism

KW - Baclofen

KW - Female

KW - Follow-Up Studies

KW - Humans

KW - Liver Transplantation

KW - Male

KW - Middle Aged

KW - Orthotopic Liver Transplantation

KW - Retrospective Studies

KW - Substance Abuse Treatment Centers

KW - Treatment Outcome

UR - http://hdl.handle.net/10807/141901

U2 - 10.1111/acer.12117

DO - 10.1111/acer.12117

M3 - Article

SN - 0145-6008

VL - 37

SP - 1601

EP - 1608

JO - ALCOHOLISM-CLINICAL AND EXPERIMENTAL RESEARCH

JF - ALCOHOLISM-CLINICAL AND EXPERIMENTAL RESEARCH

ER -

Liver transplantation in alcoholic patients: Impact of an alcohol addiction unit within a liver transplant center

Abstract

Keywords

UN SDGs

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