Department of Psychiatry, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Am J Transplant. 2010 Oct;10(10):2305-12. doi: 10.1111/j.1600-6143.2010.03232.x. Epub 2010 Aug 19.
Any use of alcohol in the years following liver transplantation (LTX) approaches 50% of patients transplanted for alcoholic liver disease (ALD). We collected detailed prospective data on alcohol consumption following LTX for ALD to investigate ongoing patterns of use. Using trajectory modeling we identified four distinct alcohol use trajectories. One group had minimal use over time. Two other groups developed early onset moderate-to-heavy consumption and one group developed late onset moderate use. These trajectories demonstrate that alcohol use varies based on timing of onset, quantity and duration. Using discriminant function analysis, we examine characteristics of recipient's pre-LTX alcohol histories and early post-LTX psychological stressors to identify the profile of those at risk for these specific trajectories. We discuss the relevance of these findings to clinical care and preliminarily to outcomes.
在接受肝移植 (LTX) 的患者中,有近 50%的患者在接受肝移植前曾有过饮酒史,这些患者的疾病大多为酒精性肝病 (ALD)。我们收集了详细的前瞻性数据,调查了ALD 患者肝移植后饮酒的情况,以研究其持续的使用模式。通过轨迹建模,我们确定了四种不同的饮酒轨迹。一组患者的饮酒量随时间的推移而减少。另外两组患者在早期出现了中等至重度饮酒,还有一组患者在晚期出现了中度饮酒。这些轨迹表明,饮酒量取决于饮酒的起始时间、数量和持续时间。通过判别函数分析,我们检查了受体在肝移植前的饮酒史和早期的心理应激因素的特点,以确定具有这些特定轨迹风险的特征。我们讨论了这些发现对临床护理的相关性,并初步探讨了其对预后的影响。