title: Predictive factors of alcohol relapse after orthotopic liver transplantation for alcoholic liver disease.
abstract: OBJECTIVE
  The objective of this prospective study was to determine whether sociological and/or alcohol-related behavioral factors could be predictive of relapse after orthotopic liver transplantation for alcoholic liver disease.
  
  
  METHODS
  Fifty-five liver-transplanted patients out of a series of 120 alcoholic cirrhotic patients were enrolled in a randomized prospective study. This study was initially designed to compare the 2 year survival in intent-to-transplant patients versus in-intent-to-use conventional treatment patients. For all patients, an identical questionnaire was completed at inclusion, and every 3 months for 5 years to collect data on alcohol-related behavior factors.
  
  
  RESULTS
  Fifty-one patients fulfilled the criteria for the study. The mean follow-up was 35.7 months (range: 1-86). Rate of alcohol relapse was 11% at one year and 30% at 2 years. Alcohol intake above 140 g a week was declared by 11% and 22% of patients at one and 2 years, respectively. The only variable leading to a significantly lower rate of relapse was abstinence for 6 months or more before liver transplantation (23% vs 79%, P=0.0003). This variable was also significant for patients whose alcohol intake was greater than 140 g per week (P=0.003) (adjusted relative risk=5.5; 95%CI=1.3-24.5; P=0.02). Multivariate analysis (Cox model) showed that abstinence for 6 months or more before liver transplantation was the unique predictive variable.
  
  
  CONCLUSIONS
  In this prospective study of 51 patients transplanted for alcoholic liver disease, abstinence before liver transplantation was the only predictive factor of alcohol relapse after liver transplantation.
authors.affiliation: Hôpital Jean Minjoz, Besançon. scoffre@club-internet.fr
authors.forename: Mathieu
authors.initials: M
authors.lastname: Miguet
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Monnet
authors.forename: Claire
authors.initials: C
authors.lastname: Vanlemmens
authors.forename: Pascal
authors.initials: P
authors.lastname: Gache
authors.forename: Michel
authors.initials: M
authors.lastname: Messner
authors.forename: Stephane
authors.initials: S
authors.lastname: Hruskovsky
authors.forename: Jean Marc
authors.initials: JM
authors.lastname: Perarnau
authors.forename: Georges-Philippe
authors.initials: GP
authors.lastname: Pageaux
authors.forename: Christophe
authors.initials: C
authors.lastname: Duvoux
authors.forename: Anne
authors.initials: A
authors.lastname: Minello
authors.forename: Patrick
authors.initials: P
authors.lastname: Hillon
authors.forename: Solange
authors.initials: S
authors.lastname: Bresson-Hadni
authors.forename: Georges
authors.initials: G
authors.lastname: Mantion
authors.forename: Jean-Philippe
authors.initials: JP
authors.lastname: Miguet
mesh_terms: D000328:Adult; D000428:Alcohol Drinking; D000437:Alcoholism; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008104:Liver Cirrhosis, Alcoholic / Q000628:therapy*; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D011446:Prospective Studies; D012008:Recurrence; D012307:Risk Factors