Gong Annie, Minuk Gerald Y
Section of Hepatology, Department of Internal Medicine, University of Manitoba, Winnipeg, Manitoba, Canada.
Department of Pharmacology and Therapeutics, University of Manitoba, Winnipeg, Manitoba, Canada.
Ann Transplant. 2018 Feb 20;23:129-135. doi: 10.12659/AOT.905646.
Demonstrated abstinence from alcohol for over six months and successful completion of a formal alcohol addictions program are two commonly employed criteria for determining whether an alcoholic patient with liver failure should proceed to liver transplantation. In this systematic review of the medical literature, we review the justification for these criteria and consider other variables that have also been reported to be of predictive value. While abstinence from alcohol for over six months is supported by the medical literature, data are more limited regarding the value of formal alcohol addictions program as selection criteria for proceeding towards liver transplantation. Positive family histories of alcoholism, co-inhabitants drinking alcohol in the presence of the patient and concurrent drug dependencies are more robust predictor variables of post-transplant recidivism. Based on the findings of this review, we propose a simple A-D transplantation selection criteria wherein "A" refers to demonstrated abstention from alcohol for over six months, "B" biology (a negative family history for alcoholism), "C", co-inhabitants not consuming alcohol in the presence of the patient; and "D", no concurrent drug dependency.
证明戒酒超过六个月且成功完成正规戒酒计划是确定患有肝衰竭的酗酒患者是否应进行肝移植的两个常用标准。在对医学文献的这项系统综述中，我们审视了这些标准的依据，并考虑了其他据报道也具有预测价值的变量。虽然医学文献支持戒酒超过六个月，但关于正规戒酒计划作为肝移植选择标准的价值的数据更为有限。酗酒的阳性家族史、患者在场时共同居住者饮酒以及并发药物依赖是移植后复发更强有力的预测变量。基于本综述的结果，我们提出一个简单的A - D移植选择标准，其中“A”指证明戒酒超过六个月，“B”指生物学因素（酗酒家族史阴性），“C”指患者在场时共同居住者不饮酒；“D”指无并发药物依赖。
