Osorio R W, Ascher N L, Avery M, Bacchetti P, Roberts J P, Lake J R
Department of Surgery, University of California, San Francisco 94143.
Hepatology. 1994 Jul;20(1 Pt 1):105-10. doi: 10.1016/0270-9139(94)90141-4.
With appropriate selection criteria, patients with end-stage alcoholic liver disease who undergo orthotopic liver transplantation have similar graft and patient survivals as patients undergoing transplantation for other causes. However, because of the possibility of recidivism after orthotopic liver transplantation there is still reluctance to transplant alcoholic patients. This study examined the association between pretransplant psychosocial variables and the risk of recidivism after orthotopic liver transplantation. At our institution, 43 patients received orthotopic liver transplantation for the referral diagnosis of alcoholic liver disease from February 1, 1988 to May 1, 1991. This represented 17% of all first transplants (43 of 257) performed during this period. Patients were interviewed before orthotopic liver transplantation by a single psychiatrist and responses to a defined set of questions were entered into a clinical database. All 43 patients diagnosed with alcoholic liver disease and a comparison group of patients transplanted for diagnoses other than alcoholic liver disease received a postoperative questionnaire regarding past and present alcohol use. Patients enrolled in the study all had at least 7 mo of follow-up, with the median follow-up being 21 mo. Eighty-six percent of alcoholic liver disease patients (37 of 43) and 86% of patients in the comparison group (37 of 43) of ALD patients agreed to participate in the study. Nineteen percent of alcoholic liver disease patients (7 of 37) and 24% of patients in the comparison group (9 of 37) admitted to having used alcohol after orthotopic liver transplantation, wtih 8% (3 of 37) and 11% (4 of 37) currently using alcohol, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)
在合适的选择标准下，接受原位肝移植的终末期酒精性肝病患者与因其他原因接受移植的患者相比，移植物和患者生存率相似。然而，由于原位肝移植后存在复发的可能性，人们仍不愿为酒精性肝病患者进行移植。本研究探讨了移植前心理社会变量与原位肝移植后复发风险之间的关联。在我们机构，从1988年2月1日至1991年5月1日，43例患者因酒精性肝病的转诊诊断接受了原位肝移植。这占该时期所有首次移植（257例中的43例）的17%。在原位肝移植前，由一名精神科医生对患者进行访谈，并将对一组特定问题的回答录入临床数据库。所有43例被诊断为酒精性肝病的患者以及一组因非酒精性肝病诊断而接受移植的对照患者，均收到一份关于过去和当前饮酒情况的术后问卷。纳入该研究的患者均至少有7个月的随访，中位随访时间为21个月。86%的酒精性肝病患者（43例中的37例）和86%的酒精性肝病对照患者组（43例中的37例）同意参与该研究。19%的酒精性肝病患者（37例中的7例）和24%的对照患者组（37例中的9例）承认在原位肝移植后饮酒，目前仍在饮酒的分别为8%（37例中的3例）和11%（37例中的4例）。（摘要截短于250字）
