Transplantation for alcoholic liver disease is becoming increasingly common, and with adequate screening, short- to medium-term outcomes are very good.
Dr Ed Day and colleagues from the United Kingdom noted during a previous prospective study that alcohol abuse or dependence was made in a number of cases in which no reference to alcohol problems had been made by the referring agency.
The researchers thus explored the characteristics of these missed cases and highlights key patient characteristics that might prompt a more detailed assessment of alcohol consumption.
|The possibility of alcohol problems had not been raised in 13% of cases|
|Liver Transplantation |
The team assessed 208 individuals completed the research interview, and of which 39% met Diagnostic and Statistical Manual of Mental Disorders IV criteria for a lifetime diagnosis of either alcohol abuse or dependence.
The researchers found that when the initial referral details were reviewed, the possibility of alcohol problems had not been raised in 13% of these cases.
Hepatitis C was the most common primary diagnosis in the missed cases.
However, the team noted no difference between diagnosed and missed cases in terms of demographic factors, severity of liver disease, or the number or degree of lifetime problems associated with alcohol.
Members of the missed group were more likely to have drunk alcohol in the past 6 months and in a greater volume.
In addition, the team noted that members of the missed group were more likely to have used illicit drugs such as opiates, amphetamines, hallucinogens, and cannabis.
Dr Day’s team concluded, “These findings point to the need to take an adequate history of lifetime alcohol problems in all patients being considered for liver transplantation.”