多学科团队对酒精性疾病肝移植后酒精复饮及生存情况的影响
Impact of a Multidisciplinary Team on Alcohol Recidivism and Survival After Liver Transplant for Alcoholic Disease.
作者信息
Magistri P, Marzi L, Guerzoni S, Vandelli M, Mereu F, Ascari F, Guidetti C, Tarantino G, Serra V, Guerrini G P, Ballarin R, Moscara M, De Maria N, Villa E, Di Benedetto F
机构信息
Hepato-Pancreato-Biliary Surgery and Liver Transplantation Unit, University of Modena and Reggio Emilia, Modena, Italy; Department of Medical and Surgical Sciences and Translational Medicine, Faculty of Medicine and Psychology, Sapienza-University of Rome, Rome, Italy.
Department of Internal Medicine, Gastroenterology Unit, University of Modena and Reggio Emilia, Modena, Italy.
出版信息
Transplant Proc. 2019 Jan-Feb;51(1):187-189. doi: 10.1016/j.transproceed.2018.02.212. Epub 2018 Jun 30.
BACKGROUND
Alcohol use disorders have a prevalence of 10% among the population of the United States and Europe and are one of the most frequent causes of liver cirrhosis in the Western world. Currently, alcohol-related liver cirrhosis represents one of the most frequent indications to liver transplant (LT), both as independent cause or associated with hepatitis C virus or hepatitis B virus infections. Starting from 2014, a multidisciplinary team involving surgeons, gastroenterologists, clinical toxicologists, psychiatrists, and psychologists was developed within the Modena Liver Transplant Center.
METHODS
We retrospectively reviewed our prospectively maintained institutional database of liver transplants in order to identify cirrhotic patients eligible for LT with a diagnosis of alcohol use disorder.
RESULTS
A total of 756 liver transplants were performed at Policlinico University Hospital, University of Modena, and Reggio Emilia, MO, Italy, between November 2000 and November 2017; 102 patients who underwent LT were considered eligible for inclusion in the study.
CONCLUSIONS
The multidisciplinary approach, together with blood, urinary, and hair tests, allows identification of early recurrences and improves survival. Further studies are necessary to understand how multidisciplinary teams can change the 6-month rule in patient selection.
背景
酒精使用障碍在美国和欧洲人口中的患病率为10%，是西方世界肝硬化最常见的病因之一。目前，酒精性肝硬化是肝移植（LT）最常见的适应证之一，无论是作为独立病因还是与丙型肝炎病毒或乙型肝炎病毒感染相关。从2014年开始，摩德纳肝移植中心组建了一个由外科医生、胃肠病学家、临床毒理学家、精神科医生和心理学家组成的多学科团队。
方法
我们回顾性分析了前瞻性维护的机构肝移植数据库，以确定符合LT标准且诊断为酒精使用障碍的肝硬化患者。
结果
2000年11月至2017年11月期间，意大利摩德纳大学雷焦艾米利亚综合大学医院共进行了756例肝移植手术；102例接受LT的患者被认为符合纳入本研究的标准。
结论
多学科方法，结合血液、尿液和毛发检测，能够识别早期复发并提高生存率。有必要进行进一步研究，以了解多学科团队如何改变患者选择中的6个月规则。
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