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Posttransplant Complications Predict Alcohol Relapse in Liver Transplant Recipients.

移植后并发症预测肝移植受者酒精复发。

  • 影响因子:2.65
  • DOI:10.1002/lt.25712
  • 作者列表:"Kitajima T","Nagai S","Segal A","Magee M","Blackburn S","Ellithorpe D","Yeddula S","Qadeer Y","Yoshida A","Moonka D","Brown K","Abouljoud MS
  • 发表时间:2020-03-01
Abstract

:Alcohol relapse after liver transplantation (LT) in patients with alcohol-related liver disease (ALD) is a major challenge. Although its association with pretransplant psychosocial factors was extensively studied, the impacts of posttransplant courses on alcohol relapse have not been well investigated. The aim of this study is to analyze peritransplant factors associated with posttransplant alcohol relapse in patients with ALD. This study evaluated 190 adult LT patients with ALD from 2013 to 2019. Risk factors for alcohol relapse were analyzed, focusing on posttransplant chronic complications, which were classified as Clavien-Dindo classification 3a or higher that lasted over 30 days. The posttransplant alcohol relapse rate was 13.7% (26/190) with a median onset time of 18.6 months after transplant. Multivariate Cox regression analysis revealed that posttransplant chronic complications were an independent risk factor for posttransplant alcohol relapse (hazard ratio [HR], 5.40; P = 0.001), along with psychiatric comorbidity (HR, 3.93; P = 0.001), history of alcohol relapse before LT (HR, 3.00; P = 0.008), and an abstinence period <1.5 years (HR, 12.05; P = 0.001). A risk prediction model was created using 3 pretransplant risk factors (psychiatric comorbidity, alcohol relapse before LT, and abstinence period <1.5 years). This model clearly stratified the risk of alcohol relapse into high-, moderate-, and low-risk groups (P < 0.001). Of the 26 patients who relapsed, 11 (42.3%) continued drinking, of whom 3 died of severe alcoholic hepatitis, and 13 (50.0%) achieved sobriety (outcomes for 2 patients were unknown). In conclusion, posttransplant chronic complications increased the risk of alcohol relapse. Recognition of posttransplant chronic complications in conjunction with the risk stratification model by pretransplant psychosocial factors would help with the prediction of posttransplant alcohol relapse.

摘要

: 酒精相关性肝病 (ALD) 患者肝移植 (LT) 后酒精复发是一大挑战。尽管对其与移植前心理社会因素的相关性进行了广泛研究,但移植后病程对酒精复发的影响尚未得到很好的研究。本研究的目的是分析与 ALD 患者移植后酒精复发相关的围手术期因素。本研究评估了 190 例成人 LT 患者 2013年至 2019年 ALD。分析酒精复发的危险因素,重点是移植后慢性并发症,分为 Clavien-Dindo 分类 3a 或更高,持续时间超过 30 天。移植后酒精复发率为 13.7% (26/190),中位发病时间为移植后 18.6 个月。多变量 Cox 回归分析显示,移植后慢性并发症是移植后酒精复发的独立危险因素 (风险比 [HR],5.40; P = 0.001),以及伴有精神合并症 (HR,3.93; P = 0.001) 、 LT 前酒精复发史 (HR,3.00; P = 0.008) 和戒断期

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影响因子:3.87
发表时间:2020-02-01
DOI:10.1111/liv.14321
作者列表:["Chen VL","Chen Y","Du X","Handelman SK","Speliotes EK"]

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翻译标题与摘要 下载文献
影响因子:2.57
发表时间:2020-02-01
DOI:10.1111/eci.13198
作者列表:["Li H","Wieser A","Zhang J","Liss I","Markwardt D","Hornung R","Neumann-Cip AC","Mayerle J","Gerbes A","Steib CJ"]

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