title: Follow-Up of Alcohol Consumption After Liver Transplantation: Interest of an Addiction Team?
abstract: Alcohol relapses after liver transplantation (LT) constitute a critical issue. Because there is no widely accepted definition of LT, its prevalence varies from 7 to 95% across studies. Only a severe relapse, the frequency of which is estimated to be 11 to 26%, decreases life expectancy after 5 years of LT and requires specific care. To improve the early identification of alcohol consumption among transplanted patients, liver transplant teams may be helped by input from an addiction team. Nevertheless, added benefit of involvement by addiction specialists in treating posttransplant patients has not been demonstrated. Thus, the aim of this study was to compare the evaluation of the alcohol consumption after LT performed routinely during the transplant consultation or obtained from a specific addiction consultation.
  
  
  
  This was a prospective single-site study. Patients were seen consecutively by their hepatologist and by an addiction specialist, and they completed the Alcohol Use Disorders Identification Test-Consumption (AUDIT-C). Thus, the patient's alcohol status was assessed using 3 different sources of information: the hepatologist's interview, the AUDIT-C score, and the addiction specialist visit.
  
  
  
  One hundred forty-one patients were consecutively evaluated. Alcohol consumption was identified by the hepatologist in 31 patients (21.9%), in 52 (36.8%) using the AUDIT-C questionnaire, and in 58 (41.1%) by the addiction specialist. The 31 patients concerned reported an average of 6.5 alcohol units/wk to the transplant physician, a number which was significantly greater (p = 0.001) by 8.6 units/wk when they were interviewed by the addiction specialist.
  
  
  
  This study highlights the clinical utility of a systematic addiction consultation among liver transplant patients, irrespective of the reason for transplantation.
authors.affiliation: Department of Addictology, Saint-Eloi Hospital, CHRU Montpellier, Montpellier, France.|INSERM, U1183, IRMB, Saint-Eloi Hospital, CHU Montpellier, Montpellier, France.
authors.forename: Hélène
authors.initials: H
authors.lastname: Donnadieu-Rigole
authors.affiliation: Department of Addictology, Saint-Eloi Hospital, CHRU Montpellier, Montpellier, France.
authors.forename: Laetitia
authors.initials: L
authors.lastname: Olive
authors.affiliation: Department of Addictology, CHU Carémeau, Nîmes, France.|DISC Inserm, Paris, France.
authors.forename: Bertrand
authors.initials: B
authors.lastname: Nalpas
authors.affiliation: Laboratory of Biostatistics, Epidemiology Clinical Research and Health Economics, IURC, EA2415, University of Montpellier, Montpellier, France.
authors.forename: Audrey
authors.initials: A
authors.lastname: Winter
authors.affiliation: Department of Hepatology and Liver Transplantation, CHU Montpellier, Montpellier, France.
authors.forename: José
authors.initials: J
authors.lastname: Ursic-Bedoya
authors.affiliation: Department of Hepatology and Liver Transplantation, CHU Montpellier, Montpellier, France.
authors.forename: Stéphanie
authors.initials: S
authors.lastname: Faure
authors.affiliation: Department of Hepatology and Liver Transplantation, CHU Montpellier, Montpellier, France.|University of Montpellier, Montpellier, Herault, France.
authors.forename: Georges-Philippe
authors.initials: GP
authors.lastname: Pageaux
authors.affiliation: Department of Addictology, CHU Carémeau, Nîmes, France.|University of Montpellier, Montpellier, Herault, France.
authors.forename: Pascal
authors.initials: P
authors.lastname: Perney
mesh_terms: D000368:Aged; D000428:Alcohol Drinking / Q000453:epidemiology / Q000523:psychology / Q000639:trends*; D016739:Behavior, Addictive / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016031:Liver Transplantation / Q000523:psychology / Q000639:trends*; D008297:Male; D008875:Middle Aged; D010348:Patient Care Team / Q000639:trends*; D011446:Prospective Studies; D012008:Recurrence
keywords: Addiction Team; Alcohol Relapse; Liver Transplantation