Factors Having an Impact on Relapse and Survival in Transplant Recipients With Alcohol-Induced Liver Disease.
Mayo Clin Proc Innov Qual Outcomes
; 5(6): 1153-1164, 2021 Dec.
Article
de En
| MEDLINE
| ID: mdl-34938953
ABSTRACT
OBJECTIVE:
To assess the impact of standardized pretransplant alcohol abstinence and treatment guidelines on liver transplant outcomes.METHODS:
This study assessed the posttransplant relapse and survival associated with a pretransplant guideline mandating alcohol abstinence, addiction treatment, and Alcoholics Anonymous (AA) attendance. This retrospective cohort study included liver recipients with alcohol-induced liver disease transplanted between January 1, 2000, and December 31, 2012, at a Midwest transplant center. Cox regression models tested for associations between pretransplant treatment, demographic and clinical characteristics, and outcome measures.RESULTS:
Of 236 liver recipients (188 [79.7%] male; 210 [89%] white; mean follow-up, 88.6±55.0 months), 212 (90.2%) completed pretransplant treatment and 135 (57.2%) attended AA weekly. At 5 years, 16.3% and 8.2% had relapsed to any alcohol use and to high-dose drinking, respectively. Smoking during the 6 months before transplant was associated with any relapse (P=.0002) and high-dose relapse (P<.0001), and smoking at transplant was associated with death (P=.001). High-dose relapse was associated with death (hazard ratio, 3.5; P<.0001).CONCLUSION:
A transplant center with a guideline requiring abstinence, treatment, and AA participation experienced lower posttransplant relapse rates from those previously reported in comparable large US transplant programs. Smoking cessation may further improve posttransplant outcomes.
Texte intégral:
1
Collection:
01-internacional
Base de données:
MEDLINE
Type d'étude:
Guideline
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Langue:
En
Journal:
Mayo Clin Proc Innov Qual Outcomes
Année:
2021
Type de document:
Article
Pays d'affiliation:
Azerbaïdjan