Liver transplantation for alcohol-associated liver disease: A call for national standards of best practices to monitor and bridge disparities in access and outcomes.
Liver transplantation for alcohol-associated liver disease: A call for national standards of best practices to monitor and bridge disparities in access and outcomes.
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DOI：
10.1016/j.ajt.2023.03.026
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发表时间：
2023-08
影响因子：
8.8
通讯作者：
Terrault, Norah A.
中科院分区：
文献类型：
--
作者：
Lee, Brian P.;Terrault, Norah A.
在美国，早期(即没有强制禁酒期)治疗酒精相关性肝病的肝移植是增长最快的肝移植适应症。尽管被广泛采用，但各移植中心的做法或政策没有标准化，监管机构也没有针对酒精的任何质量指标，所有这些都可能导致移植机会和患者结果之间确实存在差异。在这篇文章中，我们提出了器官采购和移植网络可以提出的新的任务和最佳实践，涉及与候选人选择、酒精使用监测以及预防和治疗早期移植候选人和受者有害酒精使用的服务相关的程序。我们希望这篇文章能激发讨论，并导致政策变化，以最大限度地提高移植护理的公平性和质量。
Early (ie, without a mandated abstinence period) liver transplantation for alcohol-associated liver disease is the fastest-growing indication for liver transplantation in the United States. Despite widespread adoption, there is no standardization of practice or policies across transplant centers, nor are there any quality metrics from regulatory organizations specific to alcohol, all of which have likely contributed to confirmed disparities in transplant access and patient outcomes. In this article, we propose new mandates and best practices that could be put forth by the organ procurement and transplantation network regarding processes related to candidate selection, monitoring of alcohol use, and services to prevent and treat harmful alcohol use among early transplant candidates and recipients. We hope that this article stimulates discussion and leads to policy changes to maximize equity and quality of transplant care.
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