title: Carbohydrate deficient transferrin for detection of alcohol relapse after orthotopic liver transplantation for alcoholic cirrhosis.
abstract: Early diagnosis and monitoring of an alcohol relapse in patients after orthotopic liver transplantation for alcoholic cirrhosis is of importance for the long-term outcome. A prospective study of 97 patients who underwent orthotopic liver transplant for alcoholic cirrhosis has been performed. All of the recipients considered for analysis survived for at least 3 months and were under the care of one specialist psychologist. Mean follow-up amounted to 48.5+/-1.4 months. The rates of alcohol relapse at 1 and 3 years after orthotopic liver transplant were 6 and 9%, respectively. Carbohydrate-deficient transferrin is a biological marker for alcohol abuse independently of liver disease and has been used for the first time ever in liver graft recipients. A total of 830 values were included prospectively in the study population. Detection of alcohol relapse had a sensitivity of 92% and a specificity of 98%. Changes in carbohydrate-deficient transferrin levels indicated clandestine and sporadic drinking after transplantation. Furthermore, clinical events were not found to influence carbohydrate-deficient transferrin, either in patients with or without alcoholic relapse. In our opinion, carbohydrate-deficient transferrin is a useful screening marker for alcohol relapse in patients after orthotopic liver transplant for alcoholic cirrhosis, to select those patients who need special attention from the psychologist.
authors.affiliation: Department of Transplant Surgery, University of Vienna, Austria.
authors.forename: G A
authors.initials: GA
authors.lastname: Berlakovich
authors.forename: T
authors.initials: T
authors.lastname: Windhager
authors.forename: E
authors.initials: E
authors.lastname: Freundorfer
authors.forename: O M
authors.initials: OM
authors.lastname: Lesch
authors.forename: R
authors.initials: R
authors.lastname: Steininger
authors.forename: F
authors.initials: F
authors.lastname: Mühlbacher
mesh_terms: D000328:Adult; D000368:Aged; D000437:Alcoholism / Q000145:classification / Q000175:diagnosis* / Q000523:psychology; D015415:Biomarkers / Q000097:blood; D000431:Ethanol / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008104:Liver Cirrhosis, Alcoholic / Q000601:surgery*; D016031:Liver Transplantation / Q000523:psychology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012008:Recurrence; D011795:Surveys and Questionnaires; D014168:Transferrin / Q000031:analogs & derivatives* / Q000378:metabolism
chemical_list: D015415:Biomarkers; D014168:Transferrin; C056759:carbohydrate-deficient transferrin; D000431:Ethanol