McCallum Seònaid, Masterton George
Department of Psychiatry, Queen Margaret Hospital, Whitefield Road, Dunfermline, Fife KY12 0RG, Scotland.
Alcohol Alcohol. 2006 Jul-Aug;41(4):358-63. doi: 10.1093/alcalc/agl033. Epub 2006 Apr 24.
To examine the evidence base for psychosocial selection criteria for liver transplant candidates with alcoholic liver disease.
Systematic review using three electronic databases supplemented by hand searches.
Out of 96 published studies, 22 were included. All but one were cohort design, most were retrospective, single centre, and small sample. Methodology varied considerably, such that meta-analysis was not feasible.
Social stability, no close relatives with an alcohol problem, older age, no repeated alcohol-treatment failures, good compliance with medical care, no current polydrug misuse, and no co-existing severe mental disorder have all been associated with future abstinence in more studies than not, in those that examined these variables. Duration of preoperative abstinence was a poor predictor. We recommend that, if predicting future abstinence is considered necessary by transplant teams, a standardized approach is agreed and deployed amongst transplant units, then audited and reviewed.
探讨酒精性肝病肝移植候选者心理社会选择标准的证据基础。
采用三个电子数据库进行系统评价，并辅以手工检索。
在96项已发表的研究中，纳入了22项。除一项外均为队列设计，大多数为回顾性、单中心且样本量较小。方法差异很大，因此荟萃分析不可行。
在研究这些变量的研究中，社会稳定、没有酗酒问题的近亲、年龄较大、没有反复戒酒失败、良好的医疗依从性、目前没有多种药物滥用以及没有并存的严重精神障碍与未来戒酒的关联在更多研究中得到证实。术前戒酒时间是一个较差的预测指标。我们建议，如果移植团队认为有必要预测未来戒酒情况，应在移植单位之间商定并采用标准化方法，然后进行审核和评估。
