Stress, Shorter Sobriety Predict Drinking Post-Transplant

Study identifies alcoholic liver disease transplant patients most likely to resume drinking

THURSDAY, Aug. 19 (HealthDay News) -- The length that a patient receiving a liver transplant due to alcoholic liver disease stays sober prior to surgery is the strongest predictor of a return to alcohol use, and those who have more life stressors immediately after transplant are more likely start drinking alcohol again, according to a study published online Aug. 19 in the American Journal of Transplantation.

Andrea DiMartini, M.D., of the University of Pittsburgh Medical Center, and colleagues studied alcohol consumption among 208 patients receiving liver transplants for alcoholic liver disease. Information was collected in pre- and post-transplant patient interviews and questionnaires and also gathered from caregivers (spouses or family members).

The researchers found that 54 percent of patients did not resume drinking post-transplant. However, for those patients who did, four patterns were observed: minimal use over time, early onset of alcohol use leading to moderate drinking, early onset accelerating to heavy drinking, and delayed onset with moderate or heavy drinking beginning years after the transplant. Also, the longer the patient had abstained from alcohol before transplant, the lower the risk of resumed drinking. Psychological stress immediately after surgery also increased the risk for resumed drinking. The patients most likely to resume drinking had more problems overall, were more stressed, were in worse health, and had less energy and more pain.

"These trajectories demonstrate that, for some patients, resumption occurs early following transplantation and recipients can quickly lose control over their drinking. For others, the resumption of moderate-to-heavy alcohol use can begin years post-liver transplantation. Thus, clinical monitoring should extend well beyond the early years post-liver transplantation," the authors write.

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