Use of a high-risk alcohol relapse scale in evaluating liver transplant candidates

Andrea DiMartini, Judy Magill, Mary Grace Fitzgerald, Ashokkumar Jain, William Irish, Gagan Khera, William Yates

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

Background: Methods to improve assessment, selection, and monitoring of patients with alcoholic cirrhosis who pursue liver transplantation are sought continuously. We chose to investigate the use of the High-Risk Alcohol Relapse (HRAR) scale in our transplant population in the hope that it would improve our ability to identify and follow patients at highest risk for alcohol relapse. Methods: Detailed alcohol histories of 207 patients evaluated for liver transplantation were collected and graded for severity by using the HRAR. The HRAR provides information on the duration of alcohol use (a measure of chronicity), daily quantity of alcohol use, and rehabilitation experiences (treatment responsiveness). Posttransplant alcohol use was monitored through clinical follow-up in the transplant clinic. Results: Although men and women had similar years of heavy drinking pretransplant, women's daily alcohol consumption was significantly less than men's. HRAR scores did not distinguish those listed for transplant from those not listed or those who drank posttransplant from those who did not. Transplant patients were predominantly in the low-risk group (83% had an HRAR score <4). Conclusions: The HRAR did not have predictive ability in our transplant population. Few of our patients were rated as high risk, and few drank posttransplant. Nevertheless, identifying patients at high risk may improve clinical care and decrease the rate of posttransplant alcohol consumption.

Original languageEnglish (US)
Pages (from-to)1198-1201
Number of pages4
JournalAlcoholism: Clinical and Experimental Research
Volume24
Issue number8
DOIs
StatePublished - Jan 1 2000

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Transplants
Liver
Alcohols
Recurrence
Aptitude
Alcohol Drinking
Liver Transplantation
Alcoholic Liver Cirrhosis
Physiologic Monitoring
Patient Selection
Population
Drinking
Patient rehabilitation
Rehabilitation

All Science Journal Classification (ASJC) codes

  • Medicine (miscellaneous)
  • Toxicology
  • Psychiatry and Mental health

Cite this

DiMartini, Andrea ; Magill, Judy ; Fitzgerald, Mary Grace ; Jain, Ashokkumar ; Irish, William ; Khera, Gagan ; Yates, William. / Use of a high-risk alcohol relapse scale in evaluating liver transplant candidates. In: Alcoholism: Clinical and Experimental Research. 2000 ; Vol. 24, No. 8. pp. 1198-1201.
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Use of a high-risk alcohol relapse scale in evaluating liver transplant candidates. / DiMartini, Andrea; Magill, Judy; Fitzgerald, Mary Grace; Jain, Ashokkumar; Irish, William; Khera, Gagan; Yates, William.

In: Alcoholism: Clinical and Experimental Research, Vol. 24, No. 8, 01.01.2000, p. 1198-1201.

Research output: Contribution to journalArticle

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AU - DiMartini, Andrea

AU - Magill, Judy

AU - Fitzgerald, Mary Grace

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AU - Khera, Gagan

AU - Yates, William

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N2 - Background: Methods to improve assessment, selection, and monitoring of patients with alcoholic cirrhosis who pursue liver transplantation are sought continuously. We chose to investigate the use of the High-Risk Alcohol Relapse (HRAR) scale in our transplant population in the hope that it would improve our ability to identify and follow patients at highest risk for alcohol relapse. Methods: Detailed alcohol histories of 207 patients evaluated for liver transplantation were collected and graded for severity by using the HRAR. The HRAR provides information on the duration of alcohol use (a measure of chronicity), daily quantity of alcohol use, and rehabilitation experiences (treatment responsiveness). Posttransplant alcohol use was monitored through clinical follow-up in the transplant clinic. Results: Although men and women had similar years of heavy drinking pretransplant, women's daily alcohol consumption was significantly less than men's. HRAR scores did not distinguish those listed for transplant from those not listed or those who drank posttransplant from those who did not. Transplant patients were predominantly in the low-risk group (83% had an HRAR score <4). Conclusions: The HRAR did not have predictive ability in our transplant population. Few of our patients were rated as high risk, and few drank posttransplant. Nevertheless, identifying patients at high risk may improve clinical care and decrease the rate of posttransplant alcohol consumption.

AB - Background: Methods to improve assessment, selection, and monitoring of patients with alcoholic cirrhosis who pursue liver transplantation are sought continuously. We chose to investigate the use of the High-Risk Alcohol Relapse (HRAR) scale in our transplant population in the hope that it would improve our ability to identify and follow patients at highest risk for alcohol relapse. Methods: Detailed alcohol histories of 207 patients evaluated for liver transplantation were collected and graded for severity by using the HRAR. The HRAR provides information on the duration of alcohol use (a measure of chronicity), daily quantity of alcohol use, and rehabilitation experiences (treatment responsiveness). Posttransplant alcohol use was monitored through clinical follow-up in the transplant clinic. Results: Although men and women had similar years of heavy drinking pretransplant, women's daily alcohol consumption was significantly less than men's. HRAR scores did not distinguish those listed for transplant from those not listed or those who drank posttransplant from those who did not. Transplant patients were predominantly in the low-risk group (83% had an HRAR score <4). Conclusions: The HRAR did not have predictive ability in our transplant population. Few of our patients were rated as high risk, and few drank posttransplant. Nevertheless, identifying patients at high risk may improve clinical care and decrease the rate of posttransplant alcohol consumption.

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