Both authors contributed equally to this work as last authors.
Determination of ethyl glucuronide in hair improves evaluation of long-term alcohol abstention in liver transplant candidates
Article first published online: 7 JUL 2013
© 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd
Volume 34, Issue 3, pages 469–476, March 2014
How to Cite
Liver Int. 2014: 34: 469–476
- Issue published online: 7 FEB 2014
- Article first published online: 7 JUL 2013
- Accepted manuscript online: 16 JUN 2013 05:53AM EST
- Manuscript Accepted: 28 MAY 2013
- Manuscript Received: 2 NOV 2012
- alcoholic liver disease;
- hair ethyl glucuronide;
- liver transplantation;
- urine ethyl glucuronide
Background & Aims
Prior to listing patients for Orthotopic liver transplantation (OLT) an abstention period of 6 months is required. Ethyl glucuronide in the hair is a new reliable marker for the assessment of alcohol consumption. Here, the diagnostic value of determining the ethyl glucuronide concentration in the hair of liver transplant candidates was evaluated.
In 63 transplant candidates with alcoholic liver cirrhosis and 25 control patients with cirrhosis of other aetiologies alcohol markers, i.e. hEtG, urine EtG, blood ethanol, methanol and carbohydrate deficient transferrin were determined in parallel to an interview with a psychologist.
A total of 19 (30%) transplant candidates admitted alcohol consumption within the last 6 months, while 39/63 (62%) were positive for at least one alcohol marker. In 52% of the 44 candidates denying alcohol consumption, abstention was disproved by detecting at least one positive alcohol marker, in 83% of cases by a positive hEtG result. In the control patients stating abstention from alcohol all hEtG tests were negative. No impact of renal or liver function on hEtG results was detected. A specificity of 98% and a positive predictive value of 92% were calculated for testing hEtG in proximal hair segment and applying a cut-off of 30 pg/mg.
In 52% of patients denying alcohol consumption within the last 6 months, alcohol abstention was disproved, in 83% of cases by hEtG testing. Therefore, hEtG is a promising new marker for the evaluation of long-term alcohol abstention in liver transplant candidates.