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新冠疫情时代酒精消费与成瘾对肝移植项目的影响

The Impact of Alcohol Consumption and Addiction on Liver Transplantation Programs in the COVID-19 Era.

作者信息

Manikat Richie, Ahmed Aijaz, Kim Donghee

机构信息

Division of Gastroenterology and Hepatology, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA.

出版信息

Hepat Med. 2023 Sep 29;15:141-149. doi: 10.2147/HMER.S384070. eCollection 2023.

Abstract

The coronavirus disease 2019 (COVID-19) pandemic has caused significant shifts in alcohol consumption patterns in the United States, with potential long-term implications for liver transplantation (LT) programs. Alcohol consumption has increased, particularly in women, leading to a rise in alcohol-related liver disease (ALD) and alcohol use disorder. Psychological distress associated with the pandemic may further exacerbate alcohol addiction. ALD is now the most common indication for LT, with higher disease severity and complex clinical presentations, demanding a fundamental transformation in LT programs. Multidisciplinary cooperation among medical specialists, telemedicine, and remote healthcare are essential strategies to address these challenges. However, barriers to telemedicine and costs must be overcome. Curbing alcohol consumption at the societal level and bolstering mental health programs to mitigate healthcare workforce moral injury are recommended to optimize patient care in the post-COVID-19 era. Adequate planning and compassionate management of finite resources will be crucial for the successful continuation of LT programs amidst the concerning trends in alcohol consumption and addiction.

摘要

2019冠状病毒病(COVID-19)大流行已导致美国的酒精消费模式发生重大转变,对肝移植(LT)项目可能产生长期影响。酒精消费量有所增加,尤其是在女性中,导致酒精性肝病(ALD)和酒精使用障碍的发病率上升。与大流行相关的心理困扰可能会进一步加剧酒精成瘾。ALD现在是LT最常见的适应症,疾病严重程度更高,临床表现复杂,这要求LT项目进行根本性变革。医学专家之间的多学科合作、远程医疗和远程医疗保健是应对这些挑战的关键策略。然而,必须克服远程医疗的障碍和成本问题。建议在社会层面抑制酒精消费,并加强心理健康项目,以减轻医护人员的精神创伤,从而在COVID-19后时代优化患者护理。在酒精消费和成瘾的相关趋势下,对有限资源进行充分规划和富有同情心的管理对于LT项目的成功持续开展至关重要。

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