For patients receiving liver or other organ transplants for diseases associated with substance use, risk for relapse posttransplantation is a prominent clinical concern.
There is little consensus regarding either the prevalence or risk factors for relapse to alcohol or illicit drug use in these patients.
Moreover, the evidence is inconsistent as to whether patients with pretransplantation substance use histories show poorer posttransplantation medical adherence.
|Average alcohol relapse rates were 6 cases per 100 patients per year|
Dr Mary Dew and colleagues from the USA conducted a meta-analysis of studies published between 1983 and 2005.
The research team estimated relapse rates, rates of nonadherence to the medical regimen, and the association of potential risk factors with these rates.
The team reported that the analysis included 54 studies.
Average alcohol relapse rates were 6 cases per 100 patients per year.
Relapse rates were 3 cases per 100 patients per year for heavy alcohol use.
The researchers found illicit drug relapse averaged 4 cases per 100 patients per year, with a significantly lower rate in liver vs other recipients.
Average rates in other areas, such as tobacco use, immunosuppressant and clinic appointment no adherence, were 2 to 10 cases per 100 patients per year.
The team found that risk factors could be examined only for relapse to any alcohol use.
Demographics and most pretransplantation characteristics showed little correlation with relapse.
Poorer social support, family alcohol history, and pretransplantation abstinence of 6 months showed small but significant associations with relapse.
Dr Dew's team concluded, "Future research should focus on improving the prediction of risk for substance use relapse, and on testing interventions to promote continued abstinence posttransplantation."