Abstracts of the 2023 Annual Meeting of the ALEH
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Introduction and ObjectivesAlcoholic cirrhosis is a leading cause of liver transplantation. However, post-transplant alcohol recurrence remains a significant challenge, affecting graft survival and patient outcomes. Identifying predictive factors for relapse is crucial for optimizing the allocation of scarce donor organs. Objetives: To evaluate the recurrence rate of alcohol consumption in patients who have undergone liver transplantation due to alcoholic cirrhosis and identify clinical and psychosocial variables predicting relapse risk.
Patients / Materials and MethodsA retrospective observational study was conducted on 167 consecutive patients who underwent liver transplantation for alcoholic cirrhosis between January 2013 and July 2023. Pre-transplant data, including demographics, alcohol consumption history, and psychosocial variables, were collected from medical records. Post-transplant alcohol consumption was assessed using the AUDIT questionnaire. Statistical analyses included chi-square tests, Fisher's exact tests, t-tests, and Mann-Whitney U tests.
Results and DiscussionAmong the 167 patients, a 5% (9/167) recurrence rate of alcohol consumption was observed. The recurrence group showed significantly lower adherence to post-transplant treatment (p=0.021) and higher rates of graft dysfunction (p<0.001) compared to the non-recurrence group. No significant differences were found in demographic variables, pre-transplant alcohol consumption, or psychological awareness of disease. The education level was lower in the recurrence group (p=0.05). The average AUDIT score in the recurrence group was 8, indicating intermediate risk. Recurrence was associated with a longer post-transplant follow-up period (p<0.001) and higher alcohol intake (median 40g/day).
ConclusionsPredicting post-transplant alcohol relapse based solely on pre-transplant indicators is complex. Lower adherence to post-transplant treatment and higher graft dysfunction rates were significant in the recurrence group. The AUDIT questionnaire was useful in assessing post-transplant alcohol consumption risk. Comprehensive pre- and post-transplant evaluations incorporating medical and psychosocial factors are needed to enhance patient long term outcomes and optimize the use of limited transplant resources.