Donnadieu-Rigole Hélène, Perney Pascal, Pageaux Georges-Philippe
CHRU de Montpellier, hôpital Saint-Éloi, service de médecine interne et addictologie, rue Augustin-Fliche, 34000 Montpellier, France; Université Montpellier I, 34000 Montpellier, France; U844 Inserm, hôpital Saint-Éloi, 34000 Montpellier, France.
CHRU de Montpellier, hôpital Saint-Éloi, service de médecine interne et addictologie, rue Augustin-Fliche, 34000 Montpellier, France; Université Montpellier I, 34000 Montpellier, France.
Presse Med. 2015 May;44(5):481-5. doi: 10.1016/j.lpm.2014.09.019. Epub 2015 Jan 24.
Liver transplantation is the gold standard treatment for terminal cirrhosis and liver cancer (if no surgical option is available). In France, the leading cause of liver transplantation is alcoholic cirrhosis. Severe alcohol relapse is often considered as a failure and concerns 11 to 26% of cases. The severe relapse causes a significant decrease in survival after 5 years of follow up, regardless of the origin of the transplantation. Predictors of relapse, like pretransplant abstinence duration, additional psychiatric co-morbidity, age, and level of social support have been assessed. However, alcohol addiction and liver transplantation are complex entities that cannot be reduced to a list of predictive factors. A multidisciplinary approach including an addiction specialist should identify and minimize the risk of severe relapse.
肝移植是终末期肝硬化和肝癌（如果没有手术选择）的金标准治疗方法。在法国，肝移植的主要原因是酒精性肝硬化。严重的酒精复饮通常被视为治疗失败，在11%至26%的病例中存在。无论移植的来源如何，严重复饮都会导致随访5年后生存率显著下降。已经评估了复饮的预测因素，如移植前戒酒时间、额外的精神共病、年龄和社会支持水平。然而，酒精成瘾和肝移植是复杂的情况，不能简化为一系列预测因素。包括成瘾专家在内的多学科方法应识别并尽量减少严重复饮的风险。
