Liver Transplantation in Alcohol-Associated Hepatitis. Benefits and Limitations of Psychosocial Selection and Support in Alcohol Relapse. The Experience of a Tertiary Center in Italy
Patients with severe alcoholic hepatitis SAH may suffer of undiagnosed psychiatric illnesses, typically depression. Assessment of prevalence and potential impact of psychiatric disturbances on alcohol relapse after LT, were the main objectives of this study. One hundred consecutive patients with SAH...
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Frontiers Media S.A.
2025-01-01
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| Series: | Transplant International |
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| Online Access: | https://www.frontierspartnerships.org/articles/10.3389/ti.2024.13451/full |
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| author | Luca S. Belli Adelaide Panariello Giovanni Perricone Paola Prandoni Raffaella Viganò Chiara Mazzarelli Chiara Becchetti Sara Giacalone Giovanna Donvito Sara Conti Paolo A. Cortesi Elena Roselli Gianpaola Monti Marco Carbone Luciano G. De Carlis Luciano G. De Carlis Mauro Percudani |
| author_facet | Luca S. Belli Adelaide Panariello Giovanni Perricone Paola Prandoni Raffaella Viganò Chiara Mazzarelli Chiara Becchetti Sara Giacalone Giovanna Donvito Sara Conti Paolo A. Cortesi Elena Roselli Gianpaola Monti Marco Carbone Luciano G. De Carlis Luciano G. De Carlis Mauro Percudani |
| author_sort | Luca S. Belli |
| collection | DOAJ |
| description | Patients with severe alcoholic hepatitis SAH may suffer of undiagnosed psychiatric illnesses, typically depression. Assessment of prevalence and potential impact of psychiatric disturbances on alcohol relapse after LT, were the main objectives of this study. One hundred consecutive patients with SAH from April 2016 to May 2023 were analyzed. All patients were evaluated by an integrated team including psychiatrists, addiction specialists and social workers. Thirty (30%) were listed, of whom 25 underwent early liver transplantation (eLT) after a median time of 36 days from the index episode of SAH with a median model for end stage liver disease (MELD) score of 36, whereas 33 (33%) were excluded, with psycho-social issues being the main cause of exclusion in 18 patients (54.5%). Twenty-four patients (96%) are currently alive after a median follow-up of 32 months from LT. Sixteen transplanted patients had major depression with or without anxiety, with 10 patients (33%) being treated with antidepressants post-LT. Overall, 4 patients (16%) relapsed into alcohol consumption after liver transplantation and 1 died of alcohol related liver disease (4%). From this experience emerged that psychiatric comorbidities are highly prevalent among patients with SAH and that their diagnosis/treatment contributed to mitigate the risk of alcohol relapse. |
| format | Article |
| id | doaj-art-8e988c8f1e944eed8b1f134225da89d4 |
| institution | Kabale University |
| issn | 1432-2277 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Transplant International |
| spelling | doaj-art-8e988c8f1e944eed8b1f134225da89d42025-01-06T04:12:33ZengFrontiers Media S.A.Transplant International1432-22772025-01-013710.3389/ti.2024.1345113451Liver Transplantation in Alcohol-Associated Hepatitis. Benefits and Limitations of Psychosocial Selection and Support in Alcohol Relapse. The Experience of a Tertiary Center in ItalyLuca S. Belli0Adelaide Panariello1Giovanni Perricone2Paola Prandoni3Raffaella Viganò4Chiara Mazzarelli5Chiara Becchetti6Sara Giacalone7Giovanna Donvito8Sara Conti9Paolo A. Cortesi10Elena Roselli11Gianpaola Monti12Marco Carbone13Luciano G. De Carlis14Luciano G. De Carlis15Mauro Percudani16Hepatology and Gastroenterology Unit, Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda, Milan, ItalyMental Diseases Unit, Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda, Milan, ItalyHepatology and Gastroenterology Unit, Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda, Milan, ItalyMental Diseases Unit, Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda, Milan, ItalyHepatology and Gastroenterology Unit, Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda, Milan, ItalyHepatology and Gastroenterology Unit, Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda, Milan, ItalyHepatology and Gastroenterology Unit, Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda, Milan, ItalyUnit for Continuity Hospital-Territory Care Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda, Milan, ItalyResearch Centre on Public Health (CESP), University of Milano-Bicocca, Monza, ItalyResearch Centre on Public Health (CESP), University of Milano-Bicocca, Monza, ItalyResearch Centre on Public Health (CESP), University of Milano-Bicocca, Monza, ItalyIntensive Care Unit, Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda, Milan, ItalyIntensive Care Unit, Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda, Milan, ItalyHepatology and Gastroenterology Unit, Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda, Milan, ItalyGeneral Surgery and Transplantation Unit, Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda, Milan, ItalyDepartment of Medicine and Surgery, University of Milano-Bicocca, Milan, ItalyMental Diseases Unit, Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda, Milan, ItalyPatients with severe alcoholic hepatitis SAH may suffer of undiagnosed psychiatric illnesses, typically depression. Assessment of prevalence and potential impact of psychiatric disturbances on alcohol relapse after LT, were the main objectives of this study. One hundred consecutive patients with SAH from April 2016 to May 2023 were analyzed. All patients were evaluated by an integrated team including psychiatrists, addiction specialists and social workers. Thirty (30%) were listed, of whom 25 underwent early liver transplantation (eLT) after a median time of 36 days from the index episode of SAH with a median model for end stage liver disease (MELD) score of 36, whereas 33 (33%) were excluded, with psycho-social issues being the main cause of exclusion in 18 patients (54.5%). Twenty-four patients (96%) are currently alive after a median follow-up of 32 months from LT. Sixteen transplanted patients had major depression with or without anxiety, with 10 patients (33%) being treated with antidepressants post-LT. Overall, 4 patients (16%) relapsed into alcohol consumption after liver transplantation and 1 died of alcohol related liver disease (4%). From this experience emerged that psychiatric comorbidities are highly prevalent among patients with SAH and that their diagnosis/treatment contributed to mitigate the risk of alcohol relapse.https://www.frontierspartnerships.org/articles/10.3389/ti.2024.13451/fullalcohol-associated hepatitisliver transplantationalcohol use disordermortalityalcohol relapsepsychiatric conditions |
| spellingShingle | Luca S. Belli Adelaide Panariello Giovanni Perricone Paola Prandoni Raffaella Viganò Chiara Mazzarelli Chiara Becchetti Sara Giacalone Giovanna Donvito Sara Conti Paolo A. Cortesi Elena Roselli Gianpaola Monti Marco Carbone Luciano G. De Carlis Luciano G. De Carlis Mauro Percudani Liver Transplantation in Alcohol-Associated Hepatitis. Benefits and Limitations of Psychosocial Selection and Support in Alcohol Relapse. The Experience of a Tertiary Center in Italy Transplant International alcohol-associated hepatitis liver transplantation alcohol use disorder mortality alcohol relapse psychiatric conditions |
| title | Liver Transplantation in Alcohol-Associated Hepatitis. Benefits and Limitations of Psychosocial Selection and Support in Alcohol Relapse. The Experience of a Tertiary Center in Italy |
| title_full | Liver Transplantation in Alcohol-Associated Hepatitis. Benefits and Limitations of Psychosocial Selection and Support in Alcohol Relapse. The Experience of a Tertiary Center in Italy |
| title_fullStr | Liver Transplantation in Alcohol-Associated Hepatitis. Benefits and Limitations of Psychosocial Selection and Support in Alcohol Relapse. The Experience of a Tertiary Center in Italy |
| title_full_unstemmed | Liver Transplantation in Alcohol-Associated Hepatitis. Benefits and Limitations of Psychosocial Selection and Support in Alcohol Relapse. The Experience of a Tertiary Center in Italy |
| title_short | Liver Transplantation in Alcohol-Associated Hepatitis. Benefits and Limitations of Psychosocial Selection and Support in Alcohol Relapse. The Experience of a Tertiary Center in Italy |
| title_sort | liver transplantation in alcohol associated hepatitis benefits and limitations of psychosocial selection and support in alcohol relapse the experience of a tertiary center in italy |
| topic | alcohol-associated hepatitis liver transplantation alcohol use disorder mortality alcohol relapse psychiatric conditions |
| url | https://www.frontierspartnerships.org/articles/10.3389/ti.2024.13451/full |
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