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Copyright ©The Author(s) 2017.
World J Hepatol. Jun 18, 2017; 9(17): 771-780
Published online Jun 18, 2017. doi: 10.4254/wjh.v9.i17.771
Table 1 Definitions of alcohol use after liver transplantation
StudyTermDefinition
Lucey et al[21]Harmful drinkingConsumption of 4 or more drinks in one day or drinking for 4 or more days in succession
Occasional slipConsumption of a limited amount of alcohol, followed by immediate procedures to re-establish abstinence
De Gottardi et al[11]Harmful drinkingConsumption greater than 40 g/d that is associated with the presence of alcohol-related damage, such as histologic features of alcoholic liver injury on biopsy
Diagnostic and Statistical Manual of Mental Disorders Version IVAlcohol abuseMeeting one of the following criteria during a 12 mo period: Use which causes failure to fulfill major role obligations at work, school or home, use which causes a hazardous situation, use which causes legal problems or use continuing in the setting of recurrent social or interpersonal problems
World Health OrganizationOccasional consumptionMen: < 20 g/d
Women: < 30 g/d
Excessive consumptionMen: > 20 g/d
Women: > 30 g/d
Table 2 Risk factors associated with alcohol relapse
Risk FactorRef.Study designSample sizeResults
Abstinence less than 6 mo pre-LTPerney et al[26] (2005)Retrospectiven = 61Associated with severe relapse to heavy drinking1
De Gottardi et al[11] (2007)Retrospectiven = 387Associated with relapse
Pfitzmann et al[15] (2007)Retrospectiven = 300Associated with relapse
Tandon et al[30] (2009)Retrospectiven = 171For every 1-mo increment increase in pre-transplant abstinence, there was a 5% decrease in the adjusted relapse rate
Karim et al[29] (2010)Retrospectiven = 80Associated with relapse and is an independent risk factor for relapse
Satapathy et al[42] (2015)Retrospectiven = 148Associated with alcohol relapse
Osorio et al[28] (1994)Retrospectiven = 43No association
Jauhar et al[27] (2004)Retrospectiven = 112No association
Björnsson et al[8] (2005)Retrospectiven = 103No association
Addolorato et al[25] (2013)Retrospectiven = 55No association
Egawa et al[40] (2014)Retrospectiven = 140No association
Abstinence < 1 yr pre-LTKelly et al[31] (2006)Retrospectiven = 100No association with harmful relapse2
Gedaly et al[79] (2008)Retrospectiven = 142Independent predictor of relapse
AgePerney et al[26] (2005)Retrospectiven = 61Alcohol relapse group was younger compared to the non-relapse group
Pfitzmann et al[15] (2007)Retrospectiven = 300Age < 40 yr of age was associated with relapse, but was not an independent risk factor
Karim et al[29] (2010)Retrospectiven = 80Age < 50 yr of age approached clinical significance for alcohol relapse
Rice et al[14] (2013)Retrospectiven = 300Alcohol relapse group was younger compared to the non-relapse group
Grąt et al[38] (2014)Retrospectiven = 97Younger age < 45 associated with relapse
Satapathy et al[42] (2015)Retrospectiven = 148Older patients had lower likelihood of alcohol relapse
De Gottardi et al[11] (2007)Retrospectiven = 387Age > 50 yr associated with relapse
Jauhar et al[27] (2004)Retrospectiven = 112No association
Björnsson et al[8] (2005)Retrospectiven = 103No association
Social supportKelly et al[31] (2006)Retrospectiven = 100Lack of partner associated with harmful alcohol relapse2
Pfitzmann et al[15] (2007)Retrospectiven = 300Absence of life companion associated with increased risk of alcohol relapse
DiMartini et al[13] (2006)Prospectiven = 167Marriage is protective against binge use
Rodrigue et al[39] (2013)Retrospectiven = 118Limited social support associated with alcohol relapse
Egawa et al[40] (2014)Retrospectiven = 140Marital status associated with alcohol relapse and harmful relapse3
Satapathy et al[42] (2015)Retrospectiven = 148Support from immediate family (spouse, parent or child) was highly correlated with reduced risk of alcohol relapse
Marital statusBjörnsson et al[8] (2005)Retrospectiven = 103No association
Psychiatric conditionDe Gottardi et al[11] (2007)Retrospectiven = 387Associated with relapse
Karim et al[29] (2010)Retrospectiven = 80Associated with relapse
Kelly et al[31] (2006)Retrospectiven = 100Previous diagnosis of a mental illness associated with harmful drinking2
DiMartini et al[13] (2006)Prospectiven = 167History of depressive disorder associated with alcohol relapse
Egawa et al[40] (2014)Retrospectiven = 140A history of treatment for psychological diseases other than alcoholism before LT is associated with risk of alcohol relapse but not harmful drinking3
Jauhar et al[27] (2004)Retrospectiven = 112Comorbid psychiatric condition had no association with relapse
EmploymentJauhar et al[27] (2004)Retrospectiven = 112No association
Perney et al[26] (2005)Retrospectiven = 61No association
Kelly et al[31] (2006)Retrospectiven = 100Previous occupation not associated with harmful drinking
Egawa et al[40] (2014)Retrospectiven = 140Post-LT occupational status not associated with alcohol relapse
Satapathy et al[42] (2015)Retrospectiven = 148Employment status at time of transplant was not associated with alcohol relapse
Cigarette smokingPageaux et al[17] (2003)Retrospectiven = 128Occasional and heavy drinkers were more likely to be cigarette smokers compared to abstinent patients
Kelly et al[31] (2006)Retrospectiven = 100Median cigarette use per day was higher in harmful alcohol relapse group
Rodrigue et al[56] (2013)Retrospectiven = 118Associated with alcohol relapse
Egawa et al[40] (2014)Retrospectiven = 140Cigarette smoking after LT associated with alcohol relapse
Satapathy et al[42] (2015)Retrospectiven = 148Active cigarette smoking at time of LT associated with alcohol relapse
Non-compliance with clinic visitsEgawa et al[40] (2014)Retrospectiven = 140Associated with alcohol relapse and harmful relapse3
Pre-LT substance abuse or alcohol treatmentDiMartini et al[13] (2006)Prospectiven = 167Prior alcohol rehabilitation was associated with relapse
Gedaly et al[79] (2008)Retrospectiven = 142Participation in rehabilitation was associated with relapse
Jauhar et al[27] (2004)Retrospectiven = 112Substance abuse treatment before LT had no association with relapse
Björnsson et al[8] (2005)Retrospectiven = 103No association