Liver Transpl. 2013 Dec;19(12):1387-95. doi: 10.1002/lt.23747.
Many liver transplantation (LT) programs require substance abuse (SA) treatment for candidates with a history of alcohol abuse. However, there are no data indicating that SA treatment prevents post-LT alcohol relapse. We examined 118 adults who underwent LT from May 2002 to February 2011 to explore the relationship between SA treatment and post-LT relapse to any alcohol use. Sixty-one patients (52%) with a history of alcohol abuse or dependence received SA treatment before LT. Relapse to any alcohol use was identified in 40 LT recipients (34%). Patients who received SA treatment before LT did not differ significantly in the rate of post-LT alcohol relapse from patients who did not receive treatment before transplantation(30% versus 39%, P = 0.20). However, patients who received SA treatment both before and after transplantation had significantly lower rates of alcohol relapse (16%) than patients who received no SA treatment (41%) or SA treatment only before LT (45%, P = 0.03). Our findings suggest that LT programs should consider placing more emphasis on the continuation of some type of SA treatment after transplantation. Future research should prospectively examine the optimal timing for SA treatment that will attenuate the risk of alcohol relapse after transplantation.
许多肝移植（LT）项目要求有酗酒史的候选人进行药物滥用（SA）治疗。然而，没有数据表明 SA 治疗可以预防 LT 后酒精复发。我们研究了 2002 年 5 月至 2011 年 2 月期间接受 LT 的 118 名成年人，以探讨 SA 治疗与 LT 后任何酒精使用的复发之间的关系。61 名（52%）有酒精滥用或依赖史的患者在 LT 前接受了 SA 治疗。在 40 名 LT 受者（34%）中发现了任何酒精使用的复发。在 LT 前接受 SA 治疗的患者与未接受治疗的患者（30%对 39%，P=0.20）在 LT 后酒精复发的比率无显著差异。然而，在 LT 前后都接受 SA 治疗的患者的酒精复发率（16%）显著低于未接受任何 SA 治疗的患者（41%）或仅在 LT 前接受 SA 治疗的患者（45%，P=0.03）。我们的研究结果表明，LT 项目应考虑在移植后更加重视继续进行某种类型的 SA 治疗。未来的研究应前瞻性地研究 SA 治疗的最佳时机，以减轻移植后酒精复发的风险。
