Sterneck Martina, Yegles Michel, Rothkirch von Gregor, Staufer Katharina, Vettorazzi Eik, Schulz Karl-Heinz, Tobias Niels, Graeser Christian, Fischer Lutz, Nashan Bjoern, Andresen-Streichert Hilke
Department of Hepatobiliary and Transplant Surgery, University Medical Center Hamburg - Eppendorf, Hamburg, Germany.
Liver Int. 2014 Mar;34(3):469-76. doi: 10.1111/liv.12243. Epub 2013 Jul 7.
BACKGROUND & AIMS: Prior to listing patients for Orthotopic liver transplantation (OLT) an abstention period of 6 months is required. Ethyl glucuronide in the hair is a new reliable marker for the assessment of alcohol consumption. Here, the diagnostic value of determining the ethyl glucuronide concentration in the hair of liver transplant candidates was evaluated.
In 63 transplant candidates with alcoholic liver cirrhosis and 25 control patients with cirrhosis of other aetiologies alcohol markers, i.e. hEtG, urine EtG, blood ethanol, methanol and carbohydrate deficient transferrin were determined in parallel to an interview with a psychologist.
A total of 19 (30%) transplant candidates admitted alcohol consumption within the last 6 months, while 39/63 (62%) were positive for at least one alcohol marker. In 52% of the 44 candidates denying alcohol consumption, abstention was disproved by detecting at least one positive alcohol marker, in 83% of cases by a positive hEtG result. In the control patients stating abstention from alcohol all hEtG tests were negative. No impact of renal or liver function on hEtG results was detected. A specificity of 98% and a positive predictive value of 92% were calculated for testing hEtG in proximal hair segment and applying a cut-off of 30 pg/mg.
In 52% of patients denying alcohol consumption within the last 6 months, alcohol abstention was disproved, in 83% of cases by hEtG testing. Therefore, hEtG is a promising new marker for the evaluation of long-term alcohol abstention in liver transplant candidates.
在将患者列入原位肝移植（OLT）名单之前，需要有6个月的戒酒期。毛发中的乙基葡萄糖醛酸是评估酒精摄入量的一种新的可靠标志物。在此，评估了测定肝移植候选者毛发中乙基葡萄糖醛酸浓度的诊断价值。
对63例酒精性肝硬化的移植候选者和25例其他病因肝硬化的对照患者，在与心理医生面谈的同时，并行测定酒精标志物，即毛发乙基葡萄糖醛酸（hEtG）、尿乙基葡萄糖醛酸、血液乙醇、甲醇和缺糖转铁蛋白。
共有19例（30%）移植候选者承认在过去6个月内有饮酒行为，而63例中有39例（62%）至少一种酒精标志物呈阳性。在44例否认饮酒的候选者中，52%通过检测到至少一种阳性酒精标志物被证明未戒酒，83%的病例是hEtG结果呈阳性。在声称戒酒的对照患者中，所有hEtG检测均为阴性。未检测到肾功能或肝功能对hEtG结果有影响。对近端毛发段hEtG检测采用30 pg/mg的临界值，计算出特异性为98%，阳性预测值为92%。
在过去6个月内否认饮酒的患者中，52%被证明未戒酒，83%的病例通过hEtG检测证实。因此，hEtG是评估肝移植候选者长期戒酒情况的一种有前景的新标志物。
