Predictive factors of alcohol relapse after orthotopic liver transplantation for alcoholic liver disease.
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.
Miguet
Mathieu
M
Hôpital Jean Minjoz, Besançon. scoffre@club-internet.fr
Monnet
Elisabeth
E
Vanlemmens
Claire
C
Gache
Pascal
P
Messner
Michel
M
Hruskovsky
Stephane
S
Perarnau
Jean Marc
JM
Pageaux
Georges-Philippe
GP
Duvoux
Christophe
C
Minello
Anne
A
Hillon
Patrick
P
Bresson-Hadni
Solange
S
Mantion
Georges
G
Miguet
Jean-Philippe
JP
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