酒精相关性肝炎的肝移植酒精复发的社会心理选择和支持的益处和局限性。意大利高等教育中心的经验。

IF 2.7 3区 医学 Q1 SURGERY Transplant International Pub Date : 2025-01-06 eCollection Date: 2024-01-01 DOI:10.3389/ti.2024.13451
Luca S Belli, Adelaide Panariello, Giovanni Perricone, Paola Prandoni, Raffaella Viganò, Chiara Mazzarelli, Chiara Becchetti, Sara Giacalone, Giovanna Donvito, Sara Conti, Paolo A Cortesi, Elena Roselli, Gianpaola Monti, Marco Carbone, Luciano G De Carlis, Mauro Percudani
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引用次数: 0

摘要

严重酒精性肝炎SAH患者可能患有未确诊的精神疾病,典型的是抑郁症。评估精神障碍对LT后酒精复发的患病率和潜在影响是本研究的主要目的。对2016年4月至2023年5月连续100例SAH患者进行分析。所有的病人都由一个包括精神病医生、成瘾专家和社会工作者在内的综合小组进行评估。列出了30例(30%),其中25例在SAH指数发作的中位时间为36天后进行了早期肝移植(eLT),终末期肝病模型(MELD)中位评分为36,而33例(33%)被排除在外,其中18例(54.5%)患者的心理社会问题是被排除在外的主要原因。24名患者(96%)在移植后中位随访32个月后仍然存活。16名移植患者有伴或不伴焦虑的重度抑郁症,10名患者(33%)在移植后接受抗抑郁药物治疗。总体而言,4名患者(16%)在肝移植后再次饮酒,1名患者死于酒精相关肝病(4%)。根据这一经验,精神合并症在SAH患者中非常普遍,他们的诊断/治疗有助于减轻酒精复发的风险。
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Liver Transplantation in Alcohol-Associated Hepatitis. Benefits and Limitations of Psychosocial Selection and Support in Alcohol Relapse. The Experience of a Tertiary Center in Italy.

Patients with severe alcoholic hepatitis SAH may suffer of undiagnosed psychiatric illnesses, typically depression. Assessment of prevalence and potential impact of psychiatric disturbances on alcohol relapse after LT, were the main objectives of this study. One hundred consecutive patients with SAH from April 2016 to May 2023 were analyzed. All patients were evaluated by an integrated team including psychiatrists, addiction specialists and social workers. Thirty (30%) were listed, of whom 25 underwent early liver transplantation (eLT) after a median time of 36 days from the index episode of SAH with a median model for end stage liver disease (MELD) score of 36, whereas 33 (33%) were excluded, with psycho-social issues being the main cause of exclusion in 18 patients (54.5%). Twenty-four patients (96%) are currently alive after a median follow-up of 32 months from LT. Sixteen transplanted patients had major depression with or without anxiety, with 10 patients (33%) being treated with antidepressants post-LT. Overall, 4 patients (16%) relapsed into alcohol consumption after liver transplantation and 1 died of alcohol related liver disease (4%). From this experience emerged that psychiatric comorbidities are highly prevalent among patients with SAH and that their diagnosis/treatment contributed to mitigate the risk of alcohol relapse.

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来源期刊
Transplant International
Transplant International 医学-外科
CiteScore
4.70
自引率
6.50%
发文量
211
审稿时长
3-8 weeks
期刊介绍: The aim of the journal is to serve as a forum for the exchange of scientific information in the form of original and high quality papers in the field of transplantation. Clinical and experimental studies, as well as editorials, letters to the editors, and, occasionally, reviews on the biology, physiology, and immunology of transplantation of tissues and organs, are published. Publishing time for the latter is approximately six months, provided major revisions are not needed. The journal is published in yearly volumes, each volume containing twelve issues. Papers submitted to the journal are subject to peer review.
期刊最新文献
Ethical Issues in Uncontrolled Donation After Circulatory Determination of Death: A Scoping Review to Reveal Areas of Broad Consensus, and Those for Future Research. Mono-HOPE Versus Dual-HOPE in Liver Transplantation: A Propensity Score-Matched Evaluation of Early Graft Outcome. Innovations in Lung Transplant Research and Practice: The Future is Now. Role of a Porcine Herpesvirus, PCMV/PRV, in Xenotransplantation. Improved Results Over Time With Bridge-to-Lung Transplantation: A 10-Year Experience of a Single High-Volume Center.
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