Division of Gastroenterology and Hepatology, Johns Hopkins University School of Medicine, 1830 East Monument Street, Suite 431, Baltimore, MD 21287, USA.
Liver Transplant, Division of Gastroenterology and Hepatology, Johns Hopkins University School of Medicine, 720 Rutland Avenue, Ross Research Building, Suite 918, Baltimore, MD 21205, USA.
Clin Liver Dis. 2021 Aug;25(3):645-671. doi: 10.1016/j.cld.2021.03.008. Epub 2021 May 26.
Severe alcoholic hepatitis portends a high risk of mortality without liver transplantation. Transplant outcomes in patients with severe alcoholic hepatitis exhibit a strong inverse association with post-transplant alcohol relapse. The ingredients most central to ameliorating alcohol relapse risk may include destigmatized post-transplant alcohol monitoring, a nonpunitive clinician-patient partnership, and multimodal therapies to maintain abstinence and mitigate high-risk drinking. We here review the core principles of post-liver transplant management specific to alcohol use disorder.
严重酒精性肝炎预示着在没有肝移植的情况下死亡率很高。在患有严重酒精性肝炎的患者中,移植的结果与移植后酒精复发呈强烈的反比关系。改善酒精复发风险的最重要因素可能包括:移植后酒精监测去耻辱化、非惩罚性医患合作关系以及维持戒酒和减少高危饮酒的多模式治疗。我们在这里回顾了针对酒精使用障碍的肝移植后管理的核心原则。