美国酒精性肝病肝移植中心实践的异质性。
Heterogeneity in Center Practices in Liver Transplantation for Alcohol-Associated Liver Disease in the United States.
机构信息
Division of Gastroenterology, Hepatology and Nutrition, University of Minnesota, Minneapolis, Minnesota, USA.
Division of Gastroenterology and Hepatology, Stanford University, Palo Alto, California, USA.
出版信息
Am J Gastroenterol. 2022 Sep 1;117(9):1530-1535. doi: 10.14309/ajg.0000000000001863. Epub 2022 Aug 1.
INTRODUCTION
Alcohol-related liver disease (ALD) is now the leading indication for liver transplantation (LT) in the United States (US). It remains unclear how centers are managing the medical and psychosocial issues associated with these patients.
METHODS
We conducted a web-based survey of LT centers in the United States to identify center-level details on peri-LT management of ALD and related issues.
RESULTS
Of the 117 adult LT centers, 100 responses (85.5%) were collected, representing all Organ Procurement and Transplantation Network regions. For alcohol-associated cirrhosis, 70.0% of the centers reported no minimum sobriety requirement while 21.0% required 6 months of sobriety. LT for severe alcohol-associated hepatitis was performed at 85.0% of the centers. Monitoring protocols for pre-LT and post-LT alcohol use varied among centers.
DISCUSSION
Our findings highlight a change in center attitudes toward LT for ALD, particularly for severe alcohol-associated hepatitis.
简介
在美国，酒精性肝病（ALD）目前是肝移植（LT）的主要适应证。目前尚不清楚各中心如何管理与这些患者相关的医疗和社会心理问题。
方法
我们对美国的 LT 中心进行了一项基于网络的调查，以确定中心层面与 ALD 围手术期管理和相关问题相关的详细信息。
结果
在 117 个成人 LT 中心中，共收集了 100 份（85.5%）回复，代表了所有器官获取和移植网络区域。对于酒精性肝硬化，70.0%的中心报告没有最低戒酒要求，而 21.0%的中心要求戒酒 6 个月。85.0%的中心对严重酒精性肝炎进行了 LT。中心之间的 LT 前和 LT 后酒精使用监测方案存在差异。
讨论
我们的研究结果强调了中心对 ALD 行 LT 的态度发生了变化，特别是对严重酒精性肝炎。
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