Unit of Addiction and Hepatology, Alcohological Regional Centre, ASL3 c/o San Martino Hospital, Genoa, Italy -
Unit of Addiction and Hepatology, Alcohological Regional Centre, ASL3 c/o San Martino Hospital, Genoa, Italy.
Minerva Gastroenterol (Torino). 2022 Sep;68(3):269-276. doi: 10.23736/S2724-5985.21.02885-0. Epub 2021 May 10.
Substance use disorders (SUDs) are often associated with alcohol use disorders (AUDs) and psychiatric comorbidities. In addition, they are often subjected to polytherapy. For these reasons SUDs patients are at greater risk of developing liver disease. In this concise review, liver damage from amphetamines, cannabinoids, cocaine and opioids is analyzed and the need to identify a possible associated alcohol use disorder is also suggested. Early identification of liver fibrosis is required in SUDs patients. Fibrosis is the most significant predictor of both prognosis and long-term survival. Its identification helps to promote the abstention from substances and alcohol. Active use of heroin, cocaine and synthetic substances is an absolute contraindication for liver transplantation. In cases of remission and adherence to a significant care path, the patient is re-evaluated. An addiction specialist should be present within the transplant team. If this is not present, a close collaboration with an addiction unit is mandatory.
物质使用障碍（SUDs）通常与酒精使用障碍（AUDs）和精神共病有关。此外，它们通常还接受多种疗法。由于这些原因，SUDs 患者发生肝病的风险更大。在这篇简明的综述中，分析了安非他命、大麻素、可卡因和阿片类药物引起的肝损伤，并建议有必要确定是否存在可能相关的酒精使用障碍。SUDs 患者需要早期识别肝纤维化。纤维化是预后和长期生存的最重要预测因素。其识别有助于促进患者戒除物质和酒精。阿片类药物、可卡因和合成物质的持续使用是肝移植的绝对禁忌证。在缓解和坚持进行重要治疗的情况下，对患者进行重新评估。移植团队中应配备成瘾专家。如果没有，则必须与成瘾科密切合作。
