Departments of Psychosomatic Medicine and Psychotherapy, University Hospital of Mainz, Mainz, Germany.
Liver Transpl. 2012 Nov;18(11):1310-5. doi: 10.1002/lt.23468.
Alcoholic liver cirrhosis (ALC) is a commonly accepted indication for liver transplantation (LT). Any alcohol consumption is considered a contraindication for LT. However, the assessment of abstinence in everyday practice mostly relies on patient self-reporting, which must be considered highly unreliable. After consumption, ethanol is eliminated by alcohol dehydrogenase, with methanol accumulating in the blood. Methanol, which is known to be a sensitive and specific indicator for recent alcohol consumption, has not been used for verifying alcohol consumption in LT assessments yet. Therefore, the purpose of this study was to test the feasibility of using methanol testing to identify recent alcohol consumption in LT candidates during routine and short-notice appointments. We compared methanol and ethanol measurements with self-reported alcohol consumption for 41 patients with ALC during the evaluation process before they were accepted onto the waiting list. In 32 of the 92 blood samples drawn from these 41 patients during the study, a relapse was detected by the methanol test. Both the ethanol test results and the self-reported data were positive in only 3 cases. Thus, the methanol test identified 29 additional cases of alcohol consumption. Furthermore, the methanol test discovered recent alcohol consumption in 5 of 10 transplant patients when both self-reported data and ethanol test results were negative. As a part of blood alcohol analysis, the methanol test is more sensitive than self-reporting and ethanol testing for the detection of recent alcohol consumption. Also, short-notice appointments for blood alcohol analysis reveal more cases of alcohol relapse than routine, long-term appointments. The measurement of methanol as a sensitive screening test for recent alcohol consumption should be implemented both in law and in daily, routine practice. Liver Transpl 18:1310-1315, 2012. © 2012 AASLD.
酒精性肝硬化（ALC）是肝移植（LT）的公认适应证。任何酒精摄入都被认为是 LT 的禁忌证。然而，在日常实践中，对禁欲的评估主要依赖于患者的自我报告，这必须被认为是极不可靠的。乙醇摄入后，由醇脱氢酶消除，甲醇在血液中积累。甲醇是最近酒精摄入的敏感和特异性指标，尚未用于验证 LT 评估中的酒精摄入，但尚未用于验证 LT 评估中的酒精摄入。因此，本研究的目的是测试使用甲醇检测在常规和紧急预约期间识别 LT 候选者最近酒精摄入的可行性。我们比较了 41 例 ALC 患者在接受等候名单前评估过程中的自我报告饮酒量与甲醇和乙醇测量值。在这项研究中，从这 41 名患者的 92 份血液样本中，有 32 份样本中发现了甲醇测试的复发。仅在 3 例中，乙醇测试结果和自我报告数据均为阳性。因此，甲醇测试鉴定了 29 例额外的饮酒病例。此外，当自我报告数据和乙醇测试结果均为阴性时，甲醇测试在 10 例移植患者中的 5 例中发现了近期的酒精摄入。作为血液酒精分析的一部分，甲醇测试比自我报告和乙醇测试更敏感，用于检测近期酒精摄入。此外，与常规、长期预约相比，紧急预约进行血液酒精分析会发现更多的酒精复发病例。应在法律和日常常规实践中实施甲醇作为近期酒精摄入的敏感筛查测试的测量。肝移植 18：1310-1315，2012。©2012 AASLD。
