Injection drug use before and after liver transplantation: a retrospective multicenter analysis on incidence and outcome.
OBJECTIVE
Injecting drug use (IDU) before and after liver transplantation (LT) is poorly described. The aim of this study was to quantify relapse and survival in this population and to describe the causes of mortality after LT.


METHODS
Past injection drug users were identified from the LT listing protocols from four centers in Switzerland and France. Data on survival and relapse were collected and used for uni- and multivariate analysis.


RESULTS
Between 1988 and 2006, we identified 59 patients with a past history of IDU. The mean age at transplantation was 42.4 yr and the majority of patients were men (84.7%). The indication for LT was for the vast majority viral cirrhosis accounting for 91.5% of cases, while alcoholic cirrhosis was 5.1%. There were 16.9% of patients who had a substitution therapy before and 6.8% who continued after LT. Two patients (3.4%) relapsed into IDU after LT and died at 18 and 41 months. The mean follow-up was 51 months. Overall survival was 84%, 66%, and 61% at 1, 5, and 10 yr after transplantation.


CONCLUSIONS
Documented IDU was rare in liver transplanted patients. Past IDU was not associated with poorer survival after LT, and relapse after LT occurred in 3.4%.
De Gottardi
Andrea
A
Gastroenterology, Hepatology and Visceral Surgery, University Hospital, Geneva, Switzerland. andrea.degottardi@gmail.com
Hilleret
Marie-Noelle
MN
Gelez
Pascale
P
La Mura
Vincenzo
V
Guillaud
Olivier
O
Majno
Pietro
P
Hadengue
Antoine
A
Morel
Philippe
P
Zarski
Jean-Pierre
JP
Fontana
Massimiliano
M
Moradpour
Darius
D
Mentha
Gilles
G
Boillot
Olivier
O
Leroy
Vincent
V
Giostra
Emiliano
E
Dumortier
Jérôme
J
D000328:Adult; D015331:Cohort Studies; D055030:Drug Users; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000175:diagnosis; D006801:Humans; D015994:Incidence; D017093:Liver Failure / Q000401:mortality* / Q000628:therapy*; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D015819:Substance Abuse, Intravenous; D015996:Survival Rate; D016896:Treatment Outcome; D055815:Young Adult