Umman Veysel, Gumus Tufan, Korucuk Ebubekir, Temel Recep, Sertoz Ozen Onen, Gunsar Fulya, Uguz Alper, Zeytunlu Murat, Emre Sukru
Department of General Surgery, Ege University Hospital, Izmir, Turkiye.
Department of Psychiatry, Ege University Hospital, Izmir, Turkiye.
Hepatol Forum. 2023 Sep 20;4(3):118-122. doi: 10.14744/hf.2023.2023.0048. eCollection 2023.
Alcohol-induced liver disease has become one of the major causes of chronic liver disease worldwide with the increasing use of alcohol in society. The most important step in treatment is cessation of alcohol consumption. In patients with advanced liver disease, the most effective treatment is liver transplantation. Careful evaluation of patients with alcoholic liver disease before transplantation can help identify those at high risk of relapsing.
Of a total of 42 patients who underwent liver transplantation for alcohol-related liver failure in our hospital between 2011 and 2022, 26 surviving patients were included in the study. Patient data were analyzed retrospectively. Demographic data, MELD score, history of alcohol consumption, alcohol treatment, post-transplant prognosis and survival were analyzed. The Barratt Impulsivity Scale-11 Short Form (BIS-11 SF) was applied to the surviving patients for impulsivity analysis to predict the possibility of relapse.
Of the 26 patients who were included in the study, all were male. The mean age at transplantation was 53 (31-71) years. Mean MELD score was 22.31 (9-36). 12 patients (46.2%) received living donor liver transplantation and 14 patients (53.8%) received cadaveric liver transplantation. 25 patients (96.2%) had no post-transplant dependence, while 1 patient (3.8%) had post-transplant dependence. 5 patients (19.2%) continued to consume alcohol after transplantation.
In our study, we observed that patients with high motor impulsivity tendency according to BSI-11 SF had alcohol relapse. We believe that revising this scale with more detailed questions for alcohol-dependent liver patients and applying it to patients before transplantation will be effective in better selection for transplantation and guiding patients to appropriate therapy and thus preventing relapse after transplantation.
随着社会中酒精使用的增加，酒精性肝病已成为全球慢性肝病的主要病因之一。治疗的最重要步骤是戒酒。对于晚期肝病患者，最有效的治疗方法是肝移植。在移植前仔细评估酒精性肝病患者有助于识别那些复发风险高的患者。
2011年至2022年期间，我院共有42例因酒精性肝衰竭接受肝移植的患者，其中26例存活患者纳入本研究。对患者数据进行回顾性分析。分析人口统计学数据、终末期肝病模型（MELD）评分、饮酒史、酒精治疗情况、移植后预后及生存情况。对存活患者应用巴雷特冲动性量表-11简表（BIS-11 SF）进行冲动性分析，以预测复发可能性。
纳入研究的26例患者均为男性。移植时的平均年龄为53（31 - 71）岁。平均MELD评分为22.31（9 - 36）。12例患者（46.2%）接受了活体肝移植，14例患者（53.8%）接受了尸体肝移植。25例患者（96.2%）移植后无依赖，1例患者（3.8%）移植后有依赖。5例患者（19.2%）移植后继续饮酒。
在我们的研究中，我们观察到根据BIS-11 SF具有高运动冲动倾向的患者会出现酒精复发。我们认为，用更详细的问题修订该量表，用于酒精依赖肝病患者，并在移植前应用于患者，将有助于更好地选择移植患者，指导患者接受适当治疗，从而预防移植后复发。
