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Urinary ethyl glucuronide (uEtG) as a marker for alcohol consumption in liver transplant candidates: a real-world cohort.
Vollmar, Johanna; Stern, Franziska; Lackner, Karl; Mildenberger, Philipp; Greif-Higer, Gertrud; Mittler, Jens; Darstein, Felix; Foerster, Friedrich; Grimm, Daniel; Marquardt, Jens Uwe; Schattenberg, Joern; Woerns, Marcus Alexander; Lang, Hauke; Galle, Peter Robert; Zimmermann, Tim.
Afiliación
  • Vollmar J; I. Department of Internal Medicine, Gastroenterology and Hepatology.
  • Stern F; Interdisciplinary Transplant Center.
  • Lackner K; I. Department of Internal Medicine, Gastroenterology and Hepatology.
  • Mildenberger P; Institute for Laboratory Medicine.
  • Greif-Higer G; Interdisciplinary Transplant Center.
  • Mittler J; Institute for Medical Biostatistics, Epidemiology and Informatics (IMBEI).
  • Darstein F; Departments of Psychosomatic Medicine and Psychotherapy.
  • Foerster F; Interdisciplinary Transplant Center.
  • Grimm D; Department of General, Abdominal and Transplantation Surgery.
  • Marquardt JU; Interdisciplinary Transplant Center.
  • Schattenberg J; I. Department of Internal Medicine, Gastroenterology and Hepatology.
  • Woerns MA; Interdisciplinary Transplant Center.
  • Lang H; I. Department of Internal Medicine, Gastroenterology and Hepatology.
  • Galle PR; Interdisciplinary Transplant Center.
  • Zimmermann T; I. Department of Internal Medicine, Gastroenterology and Hepatology.
Z Gastroenterol ; 58(1): 30-38, 2020 Jan.
Article en En | MEDLINE | ID: mdl-31931538
ABSTRACT

BACKGROUND:

In order to reduce alcohol relapse after liver transplantation (LT), the German national guidelines for waiting-list maintenance and organ allocation demand a minimum 6-month period of alcohol abstinence pre-LT, confirmed by measuring urinary ethyl glucuronide (uEtG).

METHODS:

Between January 2015 and June 2016, uEtG was measured at least once in 339 cirrhotic patients with an indication for LT at the University Medical Center Mainz. uEtG was measured with an enzyme-linked immunosorbent assay (ELISA) screening test (cutoff value 500 µg/L). For uEtG values ≥ 500 µg/L, liquid chromatography-mass spectrometry (LC-MS/MS) was performed as a confirmatory assay. Data were collected prospectively in a transplant database.

RESULTS:

Of the 339 potential liver transplant candidates, uEtG was negative in 86.4 %. Most patients were male (64.3 %), with an average age of 56.42 ±â€Š10.1 years. In the multivariate analysis, mean corpuscular volume (p = 0.001), urinary creatinine (p = 0.001), gamma-glutamyl transferase (p = 0.001), and hemoglobin (p = 0.003) were significantly associated with a positive uEtG test result. The sensitivity of the ELISA screening test was 100 % for uEtG values > 2000 µg/L, as confirmed by LC-MS/MS.

CONCLUSION:

uEtG is an effective parameter to reveal alcohol consumption by patients on the waiting list for LT. The sensitivity of the ELISA is excellent for uEtG values > 2000 µg/L, for which LC-MS/MS confirmation could be omitted.
Asunto(s)

Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Consumo de Bebidas Alcohólicas / Tamizaje Masivo / Trasplante de Hígado / Glucuronatos / Cirrosis Hepática Alcohólica Tipo de estudio: Diagnostic_studies / Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies / Screening_studies Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Z Gastroenterol Año: 2020 Tipo del documento: Article

Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Consumo de Bebidas Alcohólicas / Tamizaje Masivo / Trasplante de Hígado / Glucuronatos / Cirrosis Hepática Alcohólica Tipo de estudio: Diagnostic_studies / Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies / Screening_studies Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Z Gastroenterol Año: 2020 Tipo del documento: Article