Assessment and follow-up of alcohol-dependent liver transplantation patients a clinical cohort
| Autor: | Paula T. Trzepacz, Mary Amanda Dew, Ronald A. Tringali, Andrea DiMartini |
|---|---|
| Rok vydání: | 1996 |
| Předmět: |
Adult
Male medicine.medical_specialty medicine.medical_treatment Population Liver transplantation Organ transplantation Sobriety Predictive Value of Tests Recurrence Risk Factors Internal medicine medicine Humans education Referral and Consultation Psychiatry education.field_of_study Recidivism business.industry Patient Selection Attendance Length of Stay Middle Aged Survival Analysis Liver Transplantation Surgery Transplantation Alcoholism Psychiatry and Mental health Female business Follow-Up Studies Cohort study |
| Zdroj: | General Hospital Psychiatry. 18:70-77 |
| ISSN: | 0163-8343 |
| DOI: | 10.1016/s0163-8343(96)00083-7 |
| Popis: | We describe pretransplantation characteristics of 103 consecutive alcoholic cirrhotics who underwent orthotopic liver transplantation over a 28-month period, and follow-up characteristics for 58 of 82 survivors. We examined whether certain pretransplantation psychiatric and demographic variables predicted posttransplantation outcomes. Patients who were sober ⩽6 months and those who died after transplantation had longer transplant hospital stays, suggesting that physiological compromise may predict posttransplant course. Using survival analyses because of variable follow-up intervals, only age over 50 years and index hospital stays greater than 1 month showed statistical trends toward predicting shorter posttransplant survival duration. Neither pretransplant sobriety, gender, nor duration of pretransplant heavy drinking predicted posttransplant survival duration. No variable, including pre-operative sobriety ⩽6 months or attendance at alcohol rehabilitation peritransplant, predicted relapse except for female gender and pretransplant unemployment, in which cases the relapse rate was doubled. Our relapse rate of 21% is comparable to recidivism rates reported from other centers and for the general alcoholic population. These findings, several of which are contrary to general beliefs, continue to challenge our presumed predictive variables in selecting the best candidates for liver transplantation. |
| Databáze: | OpenAIRE |
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