title: Strong predictors for alcohol recidivism after liver transplantation: non-acceptance of the alcohol problem and abstinence of <3 months.
abstract: OBJECTIVE
  Alcohol-toxic liver cirrhosis (ALC) is one of the main indications for liver transplantation (LT). The aim of the study is to define predictors for alcohol recidivism and to identify the outcome and quality of life of such patients.
  
  
  METHODS
  From March 2003 to July 2009, 226 patients underwent LT in our centre. In 53% liver cirrhosis was caused by alcohol abuse (sole/cofactor). Outcome and alcohol recidivism were assessed using patients' records, laboratory tests and interviews (patient, family members and family doctor). Furthermore, patients received an SF-36 quality of life and a self-designed questionnaire anonymously.
  
  
  RESULTS
  Mean follow-up after LT was 31 + 23 months. The 5-year survival rate after LT in patients with ALC was significantly better compared to patients with other indications (78 vs. 64%; p = 0.016). Quality of life of both patient groups was comparable. After LT, alcohol recidivism rate was 16%. Patients with an alcohol abstinence of <3 months before LT had a significantly higher (p = 0.012) rate of alcohol recidivism in comparison to those with an abstinence of >3 months. Another predictor for alcohol recidivism was the patients' non-acceptance of having an alcohol problem before LT (p = 0.001).
  
  
  CONCLUSIONS
  ALC is a good indication for LT. An alcohol abstinence of <3 months before LT and a non-acceptance of having an alcohol problem are strong predictors for alcohol recidivism after LT.
authors.affiliation: Department of Internal Medicine I, University Hospital of Regensburg, Regensburg, Germany.
authors.forename: Janine
authors.initials: J
authors.lastname: Hartl
authors.forename: Marcus N
authors.initials: MN
authors.lastname: Scherer
authors.forename: Martin
authors.initials: M
authors.lastname: Loss
authors.forename: Andreas
authors.initials: A
authors.lastname: Schnitzbauer
authors.forename: Stefan
authors.initials: S
authors.lastname: Farkas
authors.forename: Lucia
authors.initials: L
authors.lastname: Baier
authors.forename: Alexander
authors.initials: A
authors.lastname: Szecsey
authors.forename: Juergen
authors.initials: J
authors.lastname: Schoelmerich
authors.forename: Hans-Juergen
authors.initials: HJ
authors.lastname: Schlitt
authors.forename: Gabriele I
authors.initials: GI
authors.lastname: Kirchner
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000437:Alcoholism / Q000523:psychology*; D003717:Denial, Psychological; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008104:Liver Cirrhosis, Alcoholic / Q000601:surgery*; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D011788:Quality of Life / Q000523:psychology; D012008:Recurrence; D018709:Statistics, Nonparametric; D016896:Treatment Outcome; D055815:Young Adult