Listabarth Stephan, König Daniel, Berlakovich Gabriela, Munda Petra, Ferenci Peter, Kollmann Dagmar, Gyöeri Georg, Waldhoer Thomas, Groemer Magdalena, van Enckevort Arjan, Vyssoki Benjamin
Clinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, 1090 Vienna, Austria.
Division of Transplantation, Department of Surgery, Medical University of Vienna, 1090 Vienna, Austria.
J Clin Med. 2022 Jun 24;11(13):3646. doi: 10.3390/jcm11133646.
Alcohol use disorder (AUD) is one of the most important risk factors for the development of alcohol-related liver cirrhosis (ALC). Importantly, psychiatrists are an integral part of the interdisciplinary care for patients with AUD and ALC. The aim of the current study was to investigate whether sex influences the outcome within this group of patients. For this purpose, data of all registrations for liver transplantations due to ALC within the Eurotransplant region from 2010 to 2019 were analyzed for sex disparities using competing risk models and in-between group comparisons. Relevant sex differences in registration numbers (24.8% female) and investigated outcomes were revealed. Risk ratios for a positive outcome, i.e., transplantation (0.74), and those of adverse outcomes, i.e., removal from waiting list (1.44) and death on waiting list (1.10), indicated a relative disadvantage for female patients with ALC. Further, women listed for liver transplantations were significantly younger than their male counterparts. Notably, sex disparities found in registration and outcome parameters were independent of differences found in the prevalence of AUD and liver transplantations. Further research is necessary to identify the underlying mechanisms and establish strategies to ensure equity and utility in liver transplantations due to ALC.
酒精使用障碍（AUD）是酒精性肝硬化（ALC）发展的最重要风险因素之一。重要的是，精神科医生是AUD和ALC患者跨学科护理不可或缺的一部分。本研究的目的是调查性别是否会影响这组患者的预后。为此，使用竞争风险模型和组间比较，对2010年至2019年欧洲移植区域内所有因ALC进行肝移植登记的数据进行了性别差异分析。结果显示，登记人数（24.8%为女性）和所调查的预后存在相关性别差异。阳性结果（即移植，风险比为0.74）以及不良结果（即从等待名单中移除，风险比为1.44；在等待名单上死亡，风险比为1.10）的风险比表明，患有ALC的女性患者相对处于劣势。此外，列入肝移植等待名单的女性明显比男性年轻。值得注意的是，在登记和预后参数中发现的性别差异与AUD患病率和肝移植中发现的差异无关。有必要进行进一步研究，以确定潜在机制，并制定策略，确保因ALC进行肝移植时的公平性和实用性。
