Liver transplantation for alcoholic liver disease: a systematic review of psychosocial selection criteria

Alcohol and Alcoholism : International Journal of the Medical Council on Alcoholism
Seònaid McCallum, George Masterton

Abstract

To examine the evidence base for psychosocial selection criteria for liver transplant candidates with alcoholic liver disease. Systematic review using three electronic databases supplemented by hand searches. 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. 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.

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