title: Determination of ethyl glucuronide in hair improves evaluation of long-term alcohol abstention in liver transplant candidates.
abstract: OBJECTIVE
  Prior to listing patients for Orthotopic liver transplantation (OLT) an abstention period of 6 months is required. Ethyl glucuronide in the hair is a new reliable marker for the assessment of alcohol consumption. Here, the diagnostic value of determining the ethyl glucuronide concentration in the hair of liver transplant candidates was evaluated.
  
  
  METHODS
  In 63 transplant candidates with alcoholic liver cirrhosis and 25 control patients with cirrhosis of other aetiologies alcohol markers, i.e. hEtG, urine EtG, blood ethanol, methanol and carbohydrate deficient transferrin were determined in parallel to an interview with a psychologist.
  
  
  RESULTS
  A total of 19 (30%) transplant candidates admitted alcohol consumption within the last 6 months, while 39/63 (62%) were positive for at least one alcohol marker. In 52% of the 44 candidates denying alcohol consumption, abstention was disproved by detecting at least one positive alcohol marker, in 83% of cases by a positive hEtG result. In the control patients stating abstention from alcohol all hEtG tests were negative. No impact of renal or liver function on hEtG results was detected. A specificity of 98% and a positive predictive value of 92% were calculated for testing hEtG in proximal hair segment and applying a cut-off of 30 pg/mg.
  
  
  CONCLUSIONS
  In 52% of patients denying alcohol consumption within the last 6 months, alcohol abstention was disproved, in 83% of cases by hEtG testing. Therefore, hEtG is a promising new marker for the evaluation of long-term alcohol abstention in liver transplant candidates.
authors.affiliation: Department of Hepatobiliary and Transplant Surgery, University Medical Center Hamburg - Eppendorf, Hamburg, Germany.
authors.forename: Martina
authors.initials: M
authors.lastname: Sterneck
authors.forename: Michel
authors.initials: M
authors.lastname: Yegles
authors.forename: Gregor
authors.initials: G
authors.lastname: Rothkirch von
authors.forename: Katharina
authors.initials: K
authors.lastname: Staufer
authors.forename: Eik
authors.initials: E
authors.lastname: Vettorazzi
authors.forename: Karl-Heinz
authors.initials: KH
authors.lastname: Schulz
authors.forename: Niels
authors.initials: N
authors.lastname: Tobias
authors.forename: Christian
authors.initials: C
authors.lastname: Graeser
authors.forename: Lutz
authors.initials: L
authors.lastname: Fischer
authors.forename: Bjoern
authors.initials: B
authors.lastname: Nashan
authors.forename: Hilke
authors.initials: H
authors.lastname: Andresen-Streichert
mesh_terms: D000328:Adult; D064829:Alcohol Abstinence; D000428:Alcohol Drinking; D015415:Biomarkers; D000431:Ethanol / Q000097:blood / Q000737:chemistry; D005260:Female; D005965:Glucuronates / Q000737:chemistry*; D006197:Hair / Q000737:chemistry*; D006801:Humans; D008104:Liver Cirrhosis, Alcoholic / Q000175:diagnosis*; D016031:Liver Transplantation; D008297:Male; D000432:Methanol / Q000097:blood / Q000737:chemistry; D008875:Middle Aged; D012680:Sensitivity and Specificity; D014168:Transferrin / Q000031:analogs & derivatives / Q000737:chemistry
chemical_list: D015415:Biomarkers; D005965:Glucuronates; D014168:Transferrin; C056759:carbohydrate-deficient transferrin; C093924:ethyl glucuronide; D000431:Ethanol; D000432:Methanol
keywords: alcoholic liver disease; cirrhosis; hair ethyl glucuronide; liver transplantation; urine ethyl glucuronide