Ricerc@Sapienza

Introduction: Alcoholic liver disease (ALD) is one of the main
indications for liver transplantation (LT) reaching about 30% in
Europe and the United States. One of the most important burden in
patients transplanted for ALD is alcohol relapse. In fact, according
to the literature, the 20–50% of patients experience alcohol relapse
in the first 5 years after LT. With this in mind, a program of program
of multidisciplinary support to alcohol misuse (MSAM) was started
up at the Transplant Unit of University of Rome “Sapienza” in 2004
involving a team of alcohol disorder specialists to help patients
undergoing LD for ALD to cope with their alcohol use disorder.
Aim: We aimed at analyze the relapse rate, risk factors for
relapse and survival in patients involved in MSAM. The relapse rate
was also compared with that of a historical group of transplanted
patients.
Material and methods: Consecutive patients with ALD
transplanted from 2004 were included. The most important demographic,
psychosocial and clinical characteristics known to be
associated with alcohol relapse were registered. Patients transplanted
for ALD before from 2000 to 2004, with no access to MSAM,
were considered as historical control group.
Results: Sixty-nine patients underwent MSAM. 8.7% presented
alcohol relapse. Relapse risk factors were female gender
(p = 0.004), history of alcohol-withdrawal-syndrome (p = 0.01), a
short follow-up before LT (p = 0.004), few sessions for support
to alcohol misuse (p = 0.003) and a short time of abstinence
before LT (p = 0.0007). The alcohol relapse rate was significantly
lower in the MSAM group vs the historical group (8.7% vs 27.7%;
p = 0.02) despite similar demographic, clinical and psychological
characteristics and a similar transplant follow-up protocol.
Five-year survival was higher than that of the historical group
(p = 0.008).
Conclusion: This study shows that aMSAM program contributes
to alcohol relapse prevention after LT in patients transplanted for
ALD.