Alcoholic liver disease (ALD) is one of the main indications for liver transplantation (LT) reaching about 30% in Europe and in the USA. According to the literature 20% > 50% of patients experience alcohol relapse in the first 5 years after LT. With this in mind, a program of multidisciplinary support to alcohol misusers (MSAM) was developed by Our Unit starting from 2004 to assist patients undergoing LT for ALD. This study aims at analyzing the relapse rate in the group of patients prospectively enrolled for MSAM and compare with a control group transplanted from 2000 to 2003, with no access to MSAM. We also analyzed the risk factors for alcohol relapse and survival. Methods: All patients with ALD transplanted from 2004 to 2013 at our University hospital were considered for the study. All patients underwent MSAM before and after LT. Patients with a follow-up shorter than 6 months were excluded from the analysis. Patients transplanted for ALD before from 2000 to 2004, with no access to MSAM, were considered as control group. For each patient the most important demographic, psychosocial and clinical characteristics known to be associated with alcohol relapse were registered. Results: A total of 69 patients underwent MSAM. Of these, 8.7% presented alcohol relapse. Relapse risk factors were female gender (p = 0.004), a history of alcohol withdrawal syndrome (p = 0.01), short follow-up before LT (p = 0.004), few sessions in the alcohol unit (p = 0.003) and short abstinence time before LT (p = 0.0007). The MSAM group presented a significantly lower alcohol relapse rate than the control group (8.7% vs. 27.7%; p = 0.02) despite similar demographic, clinical and psychological characteristics. The 5-year survival rate was higher than that of the historical group (p = 0.008). Conclusions: This study shows that the MSAM program contributes to alcohol relapse prevention after LT in patients transplanted for ALD and improves 5 years survival in patients transplanted for ALD.
The impact of multidisciplinary support to alcohol misusers at risk of alcohol relapse after liver transplantation / Lattanzi, B.; Ledda, R.; Di Gregorio, V.; Galli, A. M.; Mennini, G.; D’Ambrosio, D.; Rossi, M.; Corradini, S. G.; Attilia, M. L.; Merli, M.. - In: JOURNAL OF HEPATOLOGY. - ISSN 0168-8278. - 66:1(2017), pp. S437-S438. [10.1016/S0168-8278(17)31246-1]
The impact of multidisciplinary support to alcohol misusers at risk of alcohol relapse after liver transplantation
Lattanzi, B.;Ledda, R.;Di Gregorio, V.;Mennini, G.;D’Ambrosio, D.;Rossi, M.;Corradini, S. G.;Attilia, M. L.;Merli, M.
2017
Abstract
Alcoholic liver disease (ALD) is one of the main indications for liver transplantation (LT) reaching about 30% in Europe and in the USA. According to the literature 20% > 50% of patients experience alcohol relapse in the first 5 years after LT. With this in mind, a program of multidisciplinary support to alcohol misusers (MSAM) was developed by Our Unit starting from 2004 to assist patients undergoing LT for ALD. This study aims at analyzing the relapse rate in the group of patients prospectively enrolled for MSAM and compare with a control group transplanted from 2000 to 2003, with no access to MSAM. We also analyzed the risk factors for alcohol relapse and survival. Methods: All patients with ALD transplanted from 2004 to 2013 at our University hospital were considered for the study. All patients underwent MSAM before and after LT. Patients with a follow-up shorter than 6 months were excluded from the analysis. Patients transplanted for ALD before from 2000 to 2004, with no access to MSAM, were considered as control group. For each patient the most important demographic, psychosocial and clinical characteristics known to be associated with alcohol relapse were registered. Results: A total of 69 patients underwent MSAM. Of these, 8.7% presented alcohol relapse. Relapse risk factors were female gender (p = 0.004), a history of alcohol withdrawal syndrome (p = 0.01), short follow-up before LT (p = 0.004), few sessions in the alcohol unit (p = 0.003) and short abstinence time before LT (p = 0.0007). The MSAM group presented a significantly lower alcohol relapse rate than the control group (8.7% vs. 27.7%; p = 0.02) despite similar demographic, clinical and psychological characteristics. The 5-year survival rate was higher than that of the historical group (p = 0.008). Conclusions: This study shows that the MSAM program contributes to alcohol relapse prevention after LT in patients transplanted for ALD and improves 5 years survival in patients transplanted for ALD.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
