Psychiatric prognostic factors in patients with alcohol-related end-stage liver disease before liver transplantation.
Discussion of selection criteria for liver transplantation in alcoholics has been controversial. The concern that there might be a return to alcohol misuse after transplantation which would cause non-compliance with post-transplantation management is not supported by recent reports. Six months of abstinence have been required generally as exclusion criterion, no other psychiatric prognostic factors have been evaluated up to now.


METHODS
In 39 consecutive patients with alcohol-related end-stage liver disease who were referred to the Surgical University Clinic of Vienna for transplantation the psychiatric prognostic factors abstinence for at least six months, motivation (defined as combination of insight into the necessity of abstinence and readiness for alcohol dependence treatment) and compliance (which was stated to be positive if the psychiatric counselling dates were kept by the patients) were evaluated regarding survival for at least one year.


RESULTS
Abstinence of at least six months failed to prove to be a positive influence on survival. In contrast, motivation and compliance proved to be good psychiatric prognosis parameters.
Röggla
H
H
Anton-Proksch-Institut, Wien-Kalksburg.
Röggla
G
G
Mühlbacher
F
F
D000328:Adult; D000437:Alcoholism / Q000401:mortality / Q000523:psychology / Q000534:rehabilitation*; D005260:Female; D006501:Hepatic Encephalopathy / Q000401:mortality / Q000523:psychology* / Q000601:surgery; D006801:Humans; D008104:Liver Cirrhosis, Alcoholic / Q000401:mortality / Q000523:psychology* / Q000601:surgery; D016031:Liver Transplantation / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D009042:Motivation; D010349:Patient Compliance / Q000523:psychology; D011183:Postoperative Complications / Q000401:mortality / Q000523:psychology; D011379:Prognosis; D012008:Recurrence; D016019:Survival Analysis; D015996:Survival Rate; D013695:Temperance