Factors Having an Impact on Relapse and Survival in Transplant Recipients With Alcohol-Induced Liver Disease
Terry D. Schneekloth, Juan Pablo Arab, Douglas A. Simonetto, Tanya M. Petterson, Shehzad K. Niazi, Daniel K. Hall‐Flavin, Victor M. Karpyak, Bhanu Prakash Kolla, James E. Roth, Walter K. Kremers, Charles B. Rosen
Abstract
OBJECTIVE: To assess the impact of standardized pretransplant alcohol abstinence and treatment guidelines on liver transplant outcomes. METHODS: This study assessed the posttransplant relapse and survival associated with a pretransplant guideline mandating alcohol abstinence, addiction treatment, and Alcoholics Anonymous (AA) attendance. This retrospective cohort study included liver recipients with alcohol-induced liver disease transplanted between January 1, 2000, and December 31, 2012, at a Midwest transplant center. Cox regression models tested for associations between pretransplant treatment, demographic and clinical characteristics, and outcome measures. RESULTS: <.0001). CONCLUSION: A transplant center with a guideline requiring abstinence, treatment, and AA participation experienced lower posttransplant relapse rates from those previously reported in comparable large US transplant programs. Smoking cessation may further improve posttransplant outcomes.