Follow-Up of Alcohol Consumption After Liver Transplantation: Interest of an Addiction Team?
Follow-Up of Alcohol Consumption After Liver Transplantation: Interest of an Addiction Team?
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DOI：
10.1111/acer.13276
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发表时间：
2017-01-01
影响因子：
3.2
通讯作者：
Perney, Pascal
中科院分区：
文献类型：
--
作者：
Donnadieu-Rigole, Helene;Olive, Laetitia;Perney, Pascal
背景：肝移植（LT）后酒精复发是一个关键问题。由于LT没有被广泛接受的定义，其患病率在各研究中从7%到95%不等。只有严重的复发，其频率估计为11%至26%，在LT 5年后会降低预期寿命，并需要特殊护理。为了改善移植患者饮酒的早期识别，肝移植团队可能会得到成瘾团队的帮助。尽管如此，成瘾专家参与治疗移植后患者的额外好处尚未得到证实。因此，本研究的目的是比较LT后的酒精消费量的评价，在移植咨询或获得一个特定的成瘾consultation.Methods：这是一个前瞻性的单点研究。患者由他们的肝病专家和成瘾专家连续观察，他们完成了酒精使用障碍识别测试-消费（AUDIT-C）。因此，患者的酒精状态进行了评估，使用3种不同的信息来源：肝病学家的采访，AUDIT-C评分，和成瘾专科vision.Results：一百四十一名患者进行了连续评估。肝脏科医生确定了31例患者（21.9%）的酒精摄入量，52例（36.8%）使用AUDIT-C问卷，58例（41.1%）由成瘾专家确定。31例患者报告的平均6.5酒精单位/周的移植医生，这是显着更大的数字（p = 0.001）8.6单位/周时，他们接受了采访的成瘾specialist.Conclusions：这项研究突出了肝移植患者的系统成瘾咨询的临床效用，无论移植的原因。
Background: Alcohol relapses after liver transplantation (LT) constitute a critical issue. Because there is no widely accepted definition of LT, its prevalence varies from 7 to 95% across studies. Only a severe relapse, the frequency of which is estimated to be 11 to 26%, decreases life expectancy after 5 years of LT and requires specific care. To improve the early identification of alcohol consumption among transplanted patients, liver transplant teams may be helped by input from an addiction team. Nevertheless, added benefit of involvement by addiction specialists in treating posttransplant patients has not been demonstrated. Thus, the aim of this study was to compare the evaluation of the alcohol consumption after LT performed routinely during the transplant consultation or obtained from a specific addiction consultation.Methods: This was a prospective single-site study. Patients were seen consecutively by their hepatologist and by an addiction specialist, and they completed the Alcohol Use Disorders Identification Test-Consumption (AUDIT-C). Thus, the patient's alcohol status was assessed using 3 different sources of information: the hepatologist's interview, the AUDIT-C score, and the addiction specialist visit.Results: One hundred forty-one patients were consecutively evaluated. Alcohol consumption was identified by the hepatologist in 31 patients (21.9%), in 52 (36.8%) using the AUDIT-C questionnaire, and in 58 (41.1%) by the addiction specialist. The 31 patients concerned reported an average of 6.5 alcohol units/wk to the transplant physician, a number which was significantly greater (p = 0.001) by 8.6 units/wk when they were interviewed by the addiction specialist.Conclusions: This study highlights the clinical utility of a systematic addiction consultation among liver transplant patients, irrespective of the reason for transplantation.