Alcoholism treatment after liver transplantation: lessons learned from a clinical trial that failed.
Alcoholic liver disease is the second most common indication for liver transplantation in the United States. The lack of alcoholism treatment studies led us to study motivational enhancement therapy (MET) plus naltrexone after transplant. The authors could not complete this study. Sixty alcoholic patients were to receive MET plus naltrexone or placebo for 6 months. Fifty men and 5 women were screened. Nine died and 15 were not approached. Of 31 approached, 20 were ineligible, 11 refused, and 5 entered but dropped out before completion. Barriers to posttransplant alcoholism included infirmity, intensive medical management, and denial for alcoholism treatment. Because 30%-50% of alcoholic patients drink after transplant, the authors suggest using MET alone pretransplant.
Department of Psychiatry, The University of Pennsylvania, Philadelphia, USA. weinreb_b@mail.trc.upenn.edu
R M
RM
Weinrieb
D H
DH
Van Horn
A T
AT
McLellan
A I
AI
Alterman
J S
JS
Calarco
C P
CP
O'Brien
M R
MR
Lucey
D000223:Adaptation, Psychological; D000328:Adult; D000437:Alcoholism / Q000517:prevention & control*; D002986:Clinical Trials as Topic; D015438:Health Behavior; D006801:Humans; D016031:Liver Transplantation / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D009271:Naltrexone / Q000627:therapeutic use*; D009292:Narcotic Antagonists / Q000627:therapeutic use*; D011184:Postoperative Period
D009292:Narcotic Antagonists; D009271:Naltrexone