Impact of a Multidisciplinary Team on Alcohol Recidivism and Survival After Liver Transplant for Alcoholic Disease

Transplant Proc. 2019 Jan-Feb;51(1):187-189. doi: 10.1016/j.transproceed.2018.02.212. Epub 2018 Jun 30.

Abstract

Background: Alcohol use disorders have a prevalence of 10% among the population of the United States and Europe and are one of the most frequent causes of liver cirrhosis in the Western world. Currently, alcohol-related liver cirrhosis represents one of the most frequent indications to liver transplant (LT), both as independent cause or associated with hepatitis C virus or hepatitis B virus infections. Starting from 2014, a multidisciplinary team involving surgeons, gastroenterologists, clinical toxicologists, psychiatrists, and psychologists was developed within the Modena Liver Transplant Center.

Methods: We retrospectively reviewed our prospectively maintained institutional database of liver transplants in order to identify cirrhotic patients eligible for LT with a diagnosis of alcohol use disorder.

Results: A total of 756 liver transplants were performed at Policlinico University Hospital, University of Modena, and Reggio Emilia, MO, Italy, between November 2000 and November 2017; 102 patients who underwent LT were considered eligible for inclusion in the study.

Conclusions: The multidisciplinary approach, together with blood, urinary, and hair tests, allows identification of early recurrences and improves survival. Further studies are necessary to understand how multidisciplinary teams can change the 6-month rule in patient selection.

MeSH terms

  • Adult
  • Alcohol Abstinence
  • Alcoholism / diagnosis*
  • Female
  • Humans
  • Italy
  • Liver Cirrhosis, Alcoholic / surgery*
  • Liver Transplantation* / mortality
  • Male
  • Middle Aged
  • Patient Care Team
  • Patient Selection*
  • Recidivism
  • Recurrence
  • Retrospective Studies
  • Treatment Outcome
  • United States