title: Determination of Ethyl Glucuronide in Hair for Detection of Alcohol Consumption in Patients After Liver Transplantation.
abstract: BACKGROUND
  Early detection of alcohol misuse in orthotopic liver transplantation recipients is essential to offer patients support and prevent organ damage. Here, ethyl glucuronide, a metabolite of ethanol found in hair (hEtG), was evaluated for detection of alcohol consumption.
  
  
  METHODS
  In 104 transplant recipients, 31 with underlying alcoholic liver disease (ALD) and 73 with non-ALD, hEtG was determined in addition to the alcohol markers urine EtG, blood ethanol, methanol, and carbohydrate-deficient transferrin. Results were compared with patients' self-reports in a questionnaire and with physicians' assessments.
  
  
  RESULTS
  By physicians' assessments, 22% of the patients were suspected of consuming alcohol regularly, although only 6% of the patients acknowledged consumption of a moderate or high amount of alcohol. By testing all markers except for hEtG, alcohol consumption was detected in 7% of the patients. When hEtG testing was added to the assessment, consumption was detected in 17% of the patients. Hair-EtG determination alone revealed chronic alcohol consumption of >10 g/d in 15% of the patients. ALD patients had a positive hEtG result significantly more often than non-ALD patients did (32% versus 8%; P = 0.003). Also, the concentration of hEtG was higher in ALD patients (P = 0.049) and revealed alcohol abuse with consumption of >60 g ethanol per day in 23% of ALD and 3% of non-ALD patients. Patients' self-reports and physicians' assessments had a low sensitivity of 27% and 67%, respectively, for detecting regular alcohol intake as indicated by hEtG.
  
  
  CONCLUSIONS
  Hair-EtG determination improved the detection of liver transplant patients who used alcohol, and revealed regular alcohol consumption in 32% of ALD and 8% of non-ALD patients.
authors.affiliation: *Department of Legal Medicine; †Department of Hepatobiliary and Transplant Surgery; ‡Department of Medical Biometry and Epidemiology; and §Department of Gastroenterology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Hilke
authors.initials: H
authors.lastname: Andresen-Streichert
authors.forename: Gregor
authors.initials: G
authors.lastname: von Rothkirch
authors.forename: Eik
authors.initials: E
authors.lastname: Vettorazzi
authors.forename: Alexander
authors.initials: A
authors.lastname: Mueller
authors.forename: Ansgar W
authors.initials: AW
authors.lastname: Lohse
authors.forename: Dorothea
authors.initials: D
authors.lastname: Frederking
authors.forename: Barbara
authors.initials: B
authors.lastname: Seegers
authors.forename: Bjoern
authors.initials: B
authors.lastname: Nashan
authors.forename: Martina
authors.initials: M
authors.lastname: Sterneck
mesh_terms: D000428:Alcohol Drinking / Q000378:metabolism*; D015415:Biomarkers / Q000032:analysis / Q000097:blood / Q000652:urine; D000431:Ethanol / Q000097:blood; D005260:Female; D005965:Glucuronates / Q000032:analysis* / Q000652:urine; D006197:Hair / Q000737:chemistry*; D006801:Humans; D016031:Liver Transplantation / Q000379:methods*; D008297:Male; D000432:Methanol / Q000097:blood; D008875:Middle Aged; D011237:Predictive Value of Tests; D015813:Substance Abuse Detection / Q000379:methods*; D014168:Transferrin / Q000031:analogs & derivatives / Q000378:metabolism
chemical_list: D015415:Biomarkers; D005965:Glucuronates; D014168:Transferrin; C056759:carbohydrate-deficient transferrin; C093924:ethyl glucuronide; D000431:Ethanol; D000432:Methanol