title: Integration of Clinical Examination, Self-Report, and Hair Ethyl Glucuronide Analysis for Evaluation of Patients With Alcoholic Liver Disease Prior to Liver Transplantation.
abstract: BACKGROUND
  A large proportion of liver transplants (LTXs) are performed due to alcoholic liver disease (ALD) in the final stage of organ insufficiency. In order to list patients for LTX, transplant centers commonly require 6 months abstinence from alcohol. However, significant differences have been reported between alcohol intake as indicated by self-report and biochemical markers of alcohol.
  
  
  OBJECTIVE
  In the present study, the usefulness of ethyl glucuronide analysis in hair (hETG) was examined during the evaluation procedure before listing patients with ALD for an LTX.
  
  
  METHODS
  Cross-sectional survey.
  
  
  METHODS
  Psychosomatic evaluation.
  
  
  METHODS
  Seventy patients with ALD prior to listing for an LTX.
  
  
  METHODS
  According to clinical assessment before listing patients with ALD (n = 233) for an LTX, hETG analysis was only performed in the patients who were assumed to deny or underreport their alcohol consumption (n = 70).
  
  
  METHODS
  The analysis of hETG by liquid chromatography-mass spectrometry, clinical interview.
  
  
  RESULTS
  By hETG analyses, 27 (38.6%) of the 70 patients tested positive for ongoing alcohol consumption.
  
  
  CONCLUSIONS
  Selective use of hETG based on the clinical interview rather than widespread screening is a possible way to detect excessive alcohol consumption in patients with ALD in the transplant setting. The primary evaluation of a patient's situation in its entirety should remain the superordinate standard procedure. An interdisciplinary approach to transplant candidates with an ALD is asked for.
authors.affiliation: Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Essen, Essen, Germany.
authors.forename: Mingo
authors.initials: M
authors.lastname: Beckmann
authors.affiliation: Department of Psychosomatic Medicine and Psychotherapy, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), University Hospital of Erlangen, Germany.
authors.forename: Georgios
authors.initials: G
authors.lastname: Paslakis
authors.affiliation: MVZ Labor Dessau GmbH, Dessau-Roßlau, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Böttcher
authors.affiliation: Department of Laboratory Medicine, Karolinska Institutet and Karolinska University Laboratory, Stockholm, Sweden.
authors.forename: Anders
authors.initials: A
authors.lastname: Helander
authors.affiliation: Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Essen, Essen, Germany Department of Psychosomatic Medicine and Psychotherapy, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), University Hospital of Erlangen, Germany yesim.erim@uk-erlangen.de.
authors.forename: Yesim
authors.initials: Y
authors.lastname: Erim
mesh_terms: D000328:Adult; D000368:Aged; D064829:Alcohol Abstinence; D000437:Alcoholism / Q000150:complications; D015415:Biomarkers; D002853:Chromatography, Liquid; D003430:Cross-Sectional Studies; D005260:Female; D005965:Glucuronates / Q000032:analysis*; D006197:Hair / Q000737:chemistry*; D006801:Humans; D007406:Interview, Psychological; D008104:Liver Cirrhosis, Alcoholic / Q000209:etiology / Q000601:surgery*; D016031:Liver Transplantation; D008297:Male; D013058:Mass Spectrometry; D008875:Middle Aged; D057566:Self Report
chemical_list: D015415:Biomarkers; D005965:Glucuronates; C093924:ethyl glucuronide
keywords: alcohol liver disease; cirrhosis; hair ethyl glucuronide; liver transplantation; psychosomatic evaluation