Copyright ©The Author(s) 2015.
World J Hepatol. Aug 18, 2015; 7(17): 2091-2099
Published online Aug 18, 2015. doi: 10.4254/wjh.v7.i17.2091
Table 1 Assessment alcoholic liver disease patients for liver transplantation
Severity alcohol use (disorder)Amount of alcohol use and baseline alcohol use (TLFB)
AUD diagnosis severe (DSM5)
Family-history AUD
Age-at-onset AUD
AbstinenceDuration pre-LT abstinence
Treatment indicatorsEarlier treatments for AUD
(Longstanding) periods of abstinence
Compliance medical treatment
Other substance (mis) use (Illicit drugs, tobacco)
SocialPartner and family
Living in supportive, clean, circumstances
Table 2 Role of the addiction specialist (team) in the screening, treatment and monitoring liver transplantation candidates
ScreeningCategoryWaiting list periodLTPost-LT physical rehabilitationLong term follow-up (> yr)
Following items need to be"Low risk"Who:Psychosocial support"Low intensity follow-up"
surveyed to decide upon which category patient will enter treatment traject:Addiction treatment team integrated within transplant/hepatology departmentpatient and family(1) Who: Addiction treatment team integrated within transplant/hepatology department; or, addiction counselor in the living area of patient
What:(2) What:
Motivation enhancement andMotivation enhancement
relapse prevention strategiesCounseling
Relapse prevention
Anticraving medication: baclofen/acamprosate
Monitoring alcohol, drug and use tobacco use
"High risk"Psychosocial support patient and family"High intensity follow-up"
Who:(1) Who:
Addiction treatment team integrated within transplant/hepatology departmentComprehensive addiction treatment program/care provide/living area patient
What:(2) What:
Motivation enhancement and relapse prevention strategiesComprehensive integrated treatment including different treatment options that can be put in function of specific patient needs:
Complex behavioral interventions helping patients to control alcohol and comorbid substance (drug, nicotine) use and prevent relapse: CBT, CRA
Diagnosis and psychosocial treatment interventions psychiatric co-morbidities
Pharmacotherapy directed at craving control (baclofen, acamprosate, nalmefene)
Availability of settings: assertive outreach, (semi) residential programs