(RxWiki News) Liver transplant patients with a history of alcohol abuse often go through a treatment program before surgery. But the temptation to drink doesn’t stop once the surgery is over.
A recent study looked at a group of liver transplant patients to see who returned to drinking after surgery.
The results of the study showed that people who went to alcohol abuse treatment both before and after a liver transplant were far less likely than other patients to return to drinking after the surgery.
"Keep up with treatment programs after liver transplant."
James R. Rodrigue, PhD, from the Transplant Institute at Beth Israel Deaconess Medical Center (BIDMC) in Boston, led this investigation into liver transplant patients and alcohol use.
According to the authors, patients with a history of alcohol abuse have nearly equal rates of good health after a liver transplant as people without a history of alcohol abuse. However, returning to alcohol consumption after having a liver transplant increases the risk of serious complications.
Many transplant programs require patients to participate in some type of substance abuse treatment program, such as Alcoholics Anonymous (AA), before their liver transplant. But there are no guarantees that pre-transplant substance abuse treatment programs will lower the rates of returning to drinking after the surgery.
Previous research has shown that as many as 50 percent of patients having a liver transplant due to alcohol-related liver disease return to drinking after the surgery.
For this study, researchers interviewed and followed 118 liver or liver-kidney transplant patients from 2002 to 2011 at BIDMC.
Before undergoing a liver transplant, 52 percent of the patients had a history of alcohol abuse and went through a substance abuse treatment program.
After receiving a liver transplant, 34 percent of the patients said they had consumed some amount of alcohol.
The researchers noted that, among the patients who returned to drinking, there was not a significant difference in relapse rates between people who had been through substance abuse treatment and those who had not (39 percent versus 30 percent, respectively).
Only 16 percent of patients who went through substance abuse treatment both before and after having a liver transplant began drinking again after surgery.
Among the patients who returned to drinking, 41 percent had not gone through any substance abuse treatment. And 45 percent had received treatment before the liver transplant, but not after.
Most of the patients who returned to drinking did so less than two years after transplant surgery. And 30 percent of the patients who returned to drinking participated in heavy drinking.
By the end of the study, 11 percent had developed liver tissue scarring from drinking after having a liver transplant. And 2 percent had further alcohol-related complications after the transplant.
“Importantly, we found that patients who received substance abuse treatment both before and after transplantation had a lower likelihood of relapse to alcohol use compared to those who received no treatment at all and those who received only substance abuse treatment before transplantation,” wrote the authors of the study.
The study authors concluded that liver transplant programs should prompt patients to continue with substance abuse treatment after transplant surgery.
"Patients in need of a liver transplant due to alcohol abuse make up a very small portion of potential transplant recipients," Michelle Segovia, Senior Communications Coordinator for the northern region of the Texas Organ Sharing Alliance (TOSA), told dailyRx News.
"More often, those on the list in need of a liver transplant are suffering from an auto-immune disease, hepatitis or some other illness. Many of the babies in need of transplants suffer from diseases such as biliary atresia, an affliction where the bile ducts inside or outside the liver don’t develop normally. The bile flow from the liver to the gallbladder gets blocked which can lead to cirrhosis of the liver," Segovia said.
"Out of the 120,000 men, women and children on the transplant list, nearly 16,000 wait for a life-saving liver transplant," she said.
This study was published in October in Liver Transplantation.
The Julie Henry Research Fund, the Center for Transplant Outcomes and Quality Improvement, and the Transplant Institute at Beth Israel Deaconess Medical Center helped support funding for this project. No conflicts of interest were declared.
