Seònaid McCallum1, George Masterton. 1. Department of Psychiatry, Queen Margaret Hospital, Whitefield Road, Dunfermline, Fife KY12 0RG, Scotland. seonaid.mccallum@faht.scot.nhs.uk
Abstract
AIMS: To examine the evidence base for psychosocial selection criteria for liver transplant candidates with alcoholic liver disease. METHOD: Systematic review using three electronic databases supplemented by hand searches. RESULTS: Out of 96 published studies, 22 were included. All but one were cohort design, most were retrospective, single centre, and small sample. Methodology varied considerably, such that meta-analysis was not feasible. CONCLUSIONS: Social stability, no close relatives with an alcohol problem, older age, no repeated alcohol-treatment failures, good compliance with medical care, no current polydrug misuse, and no co-existing severe mental disorder have all been associated with future abstinence in more studies than not, in those that examined these variables. Duration of preoperative abstinence was a poor predictor. We recommend that, if predicting future abstinence is considered necessary by transplant teams, a standardized approach is agreed and deployed amongst transplant units, then audited and reviewed.
AIMS: To examine the evidence base for psychosocial selection criteria for liver transplant candidates with alcoholic liver disease. METHOD: Systematic review using three electronic databases supplemented by hand searches. RESULTS: Out of 96 published studies, 22 were included. All but one were cohort design, most were retrospective, single centre, and small sample. Methodology varied considerably, such that meta-analysis was not feasible. CONCLUSIONS: Social stability, no close relatives with an alcohol problem, older age, no repeated alcohol-treatment failures, good compliance with medical care, no current polydrug misuse, and no co-existing severe mental disorder have all been associated with future abstinence in more studies than not, in those that examined these variables. Duration of preoperative abstinence was a poor predictor. We recommend that, if predicting future abstinence is considered necessary by transplant teams, a standardized approach is agreed and deployed amongst transplant units, then audited and reviewed.
Authors: Manuela G Neuman; Lawrence Cohen; Samir Zakhari; Radu M Nanau; Sebastian Mueller; Michelle Schneider; Charles Parry; Romina Isip; Helmut K Seitz Journal: Alcohol Alcohol Date: 2014-05-09 Impact factor: 2.826