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


Journal

Transplantation proceedings
ISSN: 1873-2623
Titre abrégé: Transplant Proc
Pays: United States
ID NLM: 0243532

Informations de publication

Date de publication:
Historique:
received: 24 12 2017
accepted: 06 02 2018
entrez: 10 2 2019
pubmed: 10 2 2019
medline: 26 3 2019
Statut: ppublish

Résumé

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. 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. 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. 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.

Sections du résumé

BACKGROUND 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 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 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 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.

Identifiants

pubmed: 30736972
pii: S0041-1345(18)30867-4
doi: 10.1016/j.transproceed.2018.02.212
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

187-189

Informations de copyright

Copyright © 2018 Elsevier Inc. All rights reserved.

Auteurs

P Magistri (P)

Hepato-Pancreato-Biliary Surgery and Liver Transplantation Unit, University of Modena and Reggio Emilia, Modena, Italy; Department of Medical and Surgical Sciences and Translational Medicine, Faculty of Medicine and Psychology, Sapienza-University of Rome, Rome, Italy.

L Marzi (L)

Department of Internal Medicine, Gastroenterology Unit, University of Modena and Reggio Emilia, Modena, Italy.

S Guerzoni (S)

Medical Toxicology, University of Modena and Reggio Emilia, Modena, Italy.

M Vandelli (M)

Clinical Psychology, Policlinico University Hospital, Modena, Italy.

F Mereu (F)

Hepato-Pancreato-Biliary Surgery and Liver Transplantation Unit, University of Modena and Reggio Emilia, Modena, Italy.

F Ascari (F)

Hepato-Pancreato-Biliary Surgery and Liver Transplantation Unit, University of Modena and Reggio Emilia, Modena, Italy.

C Guidetti (C)

Hepato-Pancreato-Biliary Surgery and Liver Transplantation Unit, University of Modena and Reggio Emilia, Modena, Italy.

G Tarantino (G)

Hepato-Pancreato-Biliary Surgery and Liver Transplantation Unit, University of Modena and Reggio Emilia, Modena, Italy.

V Serra (V)

Hepato-Pancreato-Biliary Surgery and Liver Transplantation Unit, University of Modena and Reggio Emilia, Modena, Italy.

G P Guerrini (GP)

Hepato-Pancreato-Biliary Surgery and Liver Transplantation Unit, University of Modena and Reggio Emilia, Modena, Italy.

R Ballarin (R)

Hepato-Pancreato-Biliary Surgery and Liver Transplantation Unit, University of Modena and Reggio Emilia, Modena, Italy.

M Moscara (M)

Department of Mental Health and Drug Abuse, AUSL, Modena, Italy.

N De Maria (N)

Department of Internal Medicine, Gastroenterology Unit, University of Modena and Reggio Emilia, Modena, Italy.

E Villa (E)

Department of Internal Medicine, Gastroenterology Unit, University of Modena and Reggio Emilia, Modena, Italy.

F Di Benedetto (F)

Hepato-Pancreato-Biliary Surgery and Liver Transplantation Unit, University of Modena and Reggio Emilia, Modena, Italy. Electronic address: fabrizio.dibenedetto@unimore.it.

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