Substance abuse treatment and its association with relapse to alcohol use after liver transplantation

Authors

  • James R. Rodrigue,

    Corresponding author
    1. Center for Transplant Outcomes and Quality Improvement, Transplant Institute, Beth Israel Deaconess Medical Center, Boston, MA
    2. Harvard Medical School, Boston, MA
    • Address reprint requests to James R. Rodrigue, Ph.D., Center for Transplant Outcomes and Quality Improvement, Transplant Institute, Beth Israel Deaconess Medical Center, 110 Francis Street, 7th Floor, Boston, MA 02215. Telephone: 617-632-9821; FAX: 617-632-9820; E-mail: jrrodrig@bidmc.harvard.edu

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  • Douglas W. Hanto,

    1. Continuing Medical Education Office, Washington University School of Medicine, St. Louis, MO
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  • Michael P. Curry

    1. Center for Transplant Outcomes and Quality Improvement, Transplant Institute, Beth Israel Deaconess Medical Center, Boston, MA
    2. Harvard Medical School, Boston, MA
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  • This research was supported in part by the Julie Henry Research Fund and the Center for Transplant Outcomes and Quality Improvement of the Transplant Institute at Beth Israel Deaconess Medical Center.

  • The authors have no conflicts of interest to disclose.

Abstract

Many liver transplantation (LT) programs require substance abuse (SA) treatment for candidates with a history of alcohol abuse. However, there are no data indicating that SA treatment prevents post-LT alcohol relapse. We examined 118 adults who underwent LT from May 2002 to February 2011 to explore the relationship between SA treatment and post-LT relapse to any alcohol use. Sixty-one patients (52%) with a history of alcohol abuse or dependence received SA treatment before LT. Relapse to any alcohol use was identified in 40 LT recipients (34%). Patients who received SA treatment before LT did not differ significantly in the rate of post-LT alcohol relapse from patients who did not receive treatment before transplantation (30% versus 39%, P = 0.20). However, patients who received SA treatment both before and after transplantation had significantly lower rates of alcohol relapse (16%) than patients who received no SA treatment (41%) or SA treatment only before LT (45%, P = 0.03). Our findings suggest that LT programs should consider placing more emphasis on the continuation of some type of SA treatment after transplantation. Future research should prospectively examine the optimal timing for SA treatment that will attenuate the risk of alcohol relapse after transplantation. Liver Transpl 19:1387–1395, 2013. © 2013 AASLD.

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