Impact of phosphatidylethanol in the surveillance for alcohol use in post-liver transplant population: A retrospective study.

IF 3 Q2 SUBSTANCE ABUSE Alcohol (Hanover, York County, Pa.) Pub Date : 2024-10-31 DOI:10.1111/acer.15474
Sergio A De La Torre, Brittney Ibrahim, Katherine Meneses, Sammy Saab, Akshay Shetty
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Abstract

Background: Alcohol-related liver disease (ALD) is the leading indication for liver transplantation in the United States. The aim of this study was to describe the impact of phosphatidylethanol (PEth) in the surveillance for alcohol use after liver transplantation.

Methods: We conducted a single-center retrospective study to assess the impact of phosphatidylethanol (PEth) for the surveillance of alcohol use and its correlation to health outcomes. We compared orthotopic liver transplant (OLT) recipients for ALD transplanted between 2016 and 2018, before the introduction of PEth, to those transplanted between 2019 and 2022, after the introduction of PEth. Alcohol relapse versus nonrelapse cohorts were also compared. Follow-up time for all cohorts was limited to 3 years post-OLT. Continuous variables were analyzed with an independent t-test and categorical variables with Fischer's exact test and chi-square test. The Kaplan-Meier method and log-rank test were used to assess alcohol-free survival.

Results: We reviewed 263 patients who were transplanted for ALD; 46 (17.5%) patients were noted to have at least one episode of alcohol relapse after their transplant. Patients with alcohol relapse had more frequent episodes of elevated liver enzymes compared with nonrelapsed patients (4.35 episodes vs. 2.46 episodes respectively, p < 0.001). The number of hospitalizations was also noted to be elevated among relapsed versus nonrelapsed patients; however, this was not statistically significant (2.85 vs. 2.50 respectively, p = 0.307). When comparing relapse rates before and after the introduction of PEth, relapses were notably detected more frequently after the introduction of PEth (17% vs. 7%, p = 0.012). No difference was noted in rates of mortality between patients who did or did not relapse.

Conclusions: Overall, PEth is an effective surveillance tool in the postliver transplant population to monitor for alcohol relapse. Early detection of relapse can lead to opportunities for early intervention to avoid alcohol-related complications.

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磷脂酰乙醇对肝移植后人群饮酒监测的影响:一项回顾性研究。
背景:酒精相关肝病(ALD)是美国肝移植的主要适应症。本研究旨在描述磷脂酰乙醇(PEth)对肝移植后酒精使用监测的影响:我们进行了一项单中心回顾性研究,以评估磷脂酰乙醇(PEth)对酒精使用监测的影响及其与健康结果的相关性。我们比较了2016年至2018年(PEth引入之前)移植的ALD正位肝移植(OLT)受者和2019年至2022年(PEth引入之后)移植的ALD受者。同时还比较了酒精复发与非复发队列。所有队列的随访时间均限制在OLT 后 3 年。连续变量采用独立t检验,分类变量采用费舍尔精确检验和卡方检验。采用卡普兰-梅耶法和对数秩检验评估无酒精生存率:我们对 263 例因 ALD 而接受移植的患者进行了回顾性分析,发现 46 例(17.5%)患者在移植后至少复发过一次酒精中毒。与未复发的患者相比,酒精复发的患者肝酶升高的频率更高(分别为 4.35 次和 2.46 次,P 结论:总体而言,PEth 是一种有效的肝病预防方法:总体而言,PEth 是肝移植后人群监测酒精复发的有效监测工具。早期发现酒精复发可为早期干预提供机会,避免酒精相关并发症的发生。
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