Behavioral Health Department, Henry Ford Health, Detroit, Michigan, USA.
Transplant Institute, Henry Ford Health, Detroit, Michigan, USA.
Clin Transplant. 2023 Nov;37(11):e15100. doi: 10.1111/ctr.15100. Epub 2023 Aug 14.
Early identification of alcohol use is crucial for informing recommendations of appropriate follow-up treatment pre-liver transplant and optimizing post-liver transplant outcomes. The purpose of the study was to investigate whether there are psychosocial factors associated with a positive PEth test.
All patients who underwent a routine pre-surgical psychological evaluation for liver transplant listing (all etiologies, including acute liver failure, dual organ, and re-transplantation) at a single health care system in 2020 were included in a retrospective chart review. Data extraction included results from PEth testing and information from the psychological evaluation (i.e., demographic, psychiatric symptoms, and cognitive functioning).
There were 158 patients (73.8%) who had a PEth test, of whom 21.5% had a positive result (n = 34). Younger age was associated with a positive PEth (p < .001). ALD status and type of ALD (hepatitis vs. cirrhosis) were also associated with a positive PEth test. Other demographic characteristics and psychiatric symptoms were not associated with a positive PEth result (p > .05).
Younger age was the only significant demographic variable associated with a positive PEth test. Given the difficulty of predicting who may be using alcohol, it may be useful to use PEth testing for all patients during the pre-liver transplant evaluation and while patients are listed for liver transplant. Early identification of alcohol use through routine PEth testing will help identify patients who are using alcohol and need further treatment for alcohol use to optimize health and post-transplant outcomes.
早期识别饮酒情况对于提供肝移植前适当的后续治疗建议以及优化肝移植后结果至关重要。本研究旨在探讨是否存在与阳性 PEth 检测结果相关的社会心理因素。
本研究回顾性分析了 2020 年在单一医疗系统接受常规术前肝移植评估的所有患者（包括急性肝衰竭、双器官和再次移植等所有病因）的病历。数据提取包括 PEth 检测结果和心理评估信息（即人口统计学、精神症状和认知功能）。
共有 158 例患者（73.8%）进行了 PEth 检测，其中 21.5%（n=34）结果阳性。年龄较小与阳性 PEth 检测结果相关（p<0.001）。ALD 状态和 ALD 类型（肝炎与肝硬化）也与阳性 PEth 检测结果相关。其他人口统计学特征和精神症状与阳性 PEth 结果无关（p>.05）。
年龄较小是唯一与阳性 PEth 检测结果相关的显著人口统计学变量。鉴于预测哪些患者可能饮酒具有一定难度，在肝移植评估期间和患者等待肝移植期间，对所有患者进行 PEth 检测可能是有用的。通过常规 PEth 检测早期识别饮酒情况，将有助于发现正在饮酒且需要进一步治疗酒精使用障碍的患者，从而优化健康和移植后结果。
