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 -
