Liver transplant recipients with a history of alcohol abuse were less likely to relapse if they underwent substance abuse treatment after their procedure in a recent study.
Researchers evaluated 118 adult liver transplant recipients treated between May 2002 and February 2011 in Boston during a mean post-procedure follow-up of 55 months. Sixty-one patients had a history of alcohol dependence or abuse who received treatment for substance abuse (SA) before transplantation, 35 who received post-transplant SA treatment, 32 who underwent pre- and post-procedure treatment and 54 who received no treatment.
Patients experienced relapse in 34% of cases. Twenty-two percent of cases were considered low intensity (one or more isolated occasions of alcohol use followed by prolonged abstinence), 48% were moderate intensity (daily or near-daily use at amounts below pretransplant levels) and30% were high intensity (alcohol amounts or frequency the same or greater than pretransplant levels).
No significant difference was observed in relapse incidence among those who did (30% of cases) or did not (39%) receive pretransplant SA treatment (P=.2). No association was observed between prior treatment and relapse intensity (P=.59), or between intensity of pretransplant treatment and relapse incidence (P=.33).
Patients who received post-transplant SA treatment were less likely to relapse than those who did not (14% of cases vs. 42%; P=.002). Participants who underwent treatment before and after transplantation were less likely to relapse (16% of cases) compared with those who received no treatment (41%) and those who only underwent pretransplant treatment (45%) (P=.03 for difference).
Multivariate analysis indicated that not receiving post-transplant SA treatment (OR=0.18; 95% CI, 0.04-0.74 for treatment recipients) and a higher Alcohol Relapse Risk Assessment score (OR=2.41; 95% CI, 1.8-3.3) were predictive of alcohol relapse after the procedure.
“While many transplant centers require candidates with a history of alcohol abuse to attend substance abuse treatment prior to transplantation, our findings emphasize the importance of continued therapy after the transplant to prevent alcohol relapse,” researcher James Rodrigue, PhD, Transplant Institute at Beth Israel Deaconess Medical Center, said in a press release.
Disclosure: The researchers report no relevant financial disclosures.