Patients who receive a liver transplant due to alcoholic liver disease need to demonstrate periods of abstinence and often attend addiction treatment before transplantation. However, alcohol use disorders can recur, as can other diseases requiring transplantation, and thus alcohol use after liver transplantation is not uncommon. A new study published today in the American Journal of Transplantation reveals that those at highest risk to drink alcohol post transplant, especially in patterns that will damage their health, can be identified potentially preventing relapse.
Researchers led by Andrea DiMartini, MD, of the University of Pittsburgh Medical Center, collected data on alcohol consumption following liver transplantation for alcoholic liver disease in 208 patients transplanted between May 1998 to August 2004.
Alcohol relapse rates following liver transplantation are low, especially when compared to the general population. Of the 208 patients, 54% had no reported alcohol use post surgery.
However, among the remaining patients who did drink alcohol again, certain patterns emerged. Two patterns show early onset of alcohol use, one moderate and one accelerating to heavy use. These patterns show that for some patients, resumption occurs early following transplantation and recipients can quickly lose control over their drinking. For others, moderate to heavy alcohol use can begin years post surgery, showing that clinical monitoring for alcohol use should extend well beyond the first one to two years post-LTX.
The researchers found that the length of sobriety prior to surgery is the most powerful predictor of return to alcohol use, e.g. shorter sobriety conferring higher risk. Additionally, stresses immediately following surgery would increase the risk of alcohol use. Those more likely to drink were experiencing more problems overall, were more stressed, reported worse health, and had more pain and less energy.
“Our findings will aid clinicians in early monitoring and identification of patients at risk for alcohol use,” DiMartini notes. “With improved methods to identify those at high risk, and effective treatments for alcohol use disorders, we can keep the relapse rates low and get patients into proper treatment before they injure their health.”
This study is published in the American Journal of Transplantation. Media wishing to receive a PDF of this article may contact [email protected]
A. DiMartini, M.A. Dew, N. Day, M.G. Fitzgerald, B.L. Jones, M.E. deVera, and P. Fontes. Trajectories of Alcohol Consumption Following Liver Transplantation. American Journal of Transplantation 2010; 10: 1-8. DOI: 10.1111/j.1600-6143.2010.03232.x
About the Author: Andrea DiMartini, MD, is affiliated with the University of Pittsburgh Medical Center, Starzl Transplant Institute.
To arrange an interview with an author, please contact Dr. DiMartini’s press office contact, Kristin Beaver, at [email protected]
About the Journal
American Journal of Transplantation reflects the field and is an agent for advancing it through critical reviews and news features, consensus documents and guidelines. The journal is directed at scientists and clinicians in transplantation but also at those in other fields who wish to follow transplantation. The scope is the international discipline of transplantation. This includes organ and tissue donation and preservation; tissue injury, repair, inflammation, and aging; immune recognition, regulation, effector mechanisms, and opportunities for induction of tolerance; histocompatibility; drugs and pharmacology relevant to transplantation; graft survival and prevention of graft dysfunction and failure; clinical trials and population analyses; transplant complications; xenotransplantation; and ethical and societal issues. The sciences includes relevant aspects of cell biology, medicine, surgery, pediatrics, and infectious diseases. The journal includes thoracic transplantation (heart, lung), abdominal transplantation (kidney, liver, pancreas, islets), transplantation of tissues and related topics.
Wiley-Blackwell is the international scientific, technical, medical, and scholarly publishing business of John Wiley & Sons, with strengths in every major academic and professional field and partnerships with many of the world’s leading societies. Wiley-Blackwell publishes nearly 1,500 peer-reviewed journals and 1,500+ new books annually in print and online, as well as databases, major reference works and laboratory protocols. For more information, please visit www.wileyblackwell.com or our new online platform, Wiley Online Library (wileyonlinelibrary.com), one of the world’s most extensive multidisciplinary collections of online resources, covering life, health, social and physical sciences, and humanities.