Successful Post-Transplant Psychiatric Interventions During Long-Term Follow-Up of Patients Receiving Liver Transplants for Alcoholic Liver Disease.
Successful Post-Transplant Psychiatric Interventions During Long-Term Follow-Up of Patients Receiving Liver Transplants for Alcoholic Liver Disease.
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DOI：
10.12659/ajcr.906446
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发表时间：
2017-11-16
期刊：
影响因子：
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通讯作者：
Ozaki N
中科院分区：
文献类型：
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作者：
Kimura H;Onishi Y;Kishi S;Kurata N;Ogiso S;Kamei H;Tsuboi C;Yamaguchi N;Shiga A;Kondo M;Yokoyama Y;Takasato F;Fujishiro H;Ishizuka K;Okada T;Ogura Y;Ozaki N
病例系列患者：男，44岁·男，44岁·女，36岁最终诊断：酒精使用障碍持续缓解症状：酒精使用复发·压力相关愤怒/刺激·唑吡坦滥用药物：-临床操作：精神病干预专长：在因酒精性肝病（ALD）而接受肝移植（LT）的患者中，约有20-30%的患者接受了肝移植（LT）。将恢复大量饮酒后LT。这是至关重要的，以控制移植后复发的酒精使用，因为酒精累犯已被证明有负面影响移植后的依从性和长期结果的LT接受者。然而，目前还没有具体的，有效的精神干预，以防止额外的酒精消费在临床实践中。我们介绍了3例在名古屋大学医院接受肝移植治疗ALD的患者，他们接受了长时间的随访（分别为7.2、8.8和11.3年），并回顾了用于解决危急情况的精神干预措施。在病例1中注意到额外的酒精消耗，但及时的合作护理导致稳定的戒酒。在案例2中，由于工作而加剧了明显的愤怒和刺激，但愤怒被愤怒管理所控制。例3滥用了一种轻微的镇静剂，但限制设置导致足够的医疗依从性。移植团队需要为酒精再犯提供综合治疗，以改善ALD LT后的长期健康状况。
Case series Patient: Male, 44 • Male, 44 • Female, 36 Final Diagnosis: Alcohol use disorders in sustained remission Symptoms: Relapse of alcohol use • stress-related anger/irritation • zolpidem abuse Medication: — Clinical Procedure: Psychiatric intervention Specialty: Transplantology Unusual setting of medical care Around 20–30% of patients who undergo liver transplantation (LT) for alcoholic liver disease (ALD) will resume heavy drinking after LT. It is crucial to control post-transplant relapse of alcohol use, because alcoholic recidivism has been shown to have a negative impact on post-transplant compliance and long-term outcomes of LT recipients. However, there is currently no specific, effective psychiatric intervention for preventing additional alcohol consumption in clinical practice. We present 3 patients who underwent LT for ALD at Nagoya University Hospital who were followed up for prolonged periods (7.2, 8.8, and 11.3 years, respectively), and review the psychiatric interventions employed to address critical situations. Additional alcohol consumption was noted in Case 1, but prompt collaborative care led to stable abstinence. In Case 2, marked anger and irritation were exacerbated as a result of work, but the anger was controlled by anger management. Case 3 abused a minor tranquilizer, but limit-setting resulted in adequate medical adherence. Transplant teams need to provide comprehensive treatment for alcoholic recidivism to improve long-term health after LT for ALD.