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首页> 外文期刊>Scandinavian journal of gastroenterology. >Long-term follow-up of patients with alcoholic liver disease after liver transplantation in Sweden: impact of structured management on recidivism.
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Long-term follow-up of patients with alcoholic liver disease after liver transplantation in Sweden: impact of structured management on recidivism.

机译：瑞典肝移植后酒精性肝病患者的长期随访：结构管理对累犯的影响。

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摘要

OBJECTIVE: No systematic evaluation has been performed previously in the Scandinavian countries on patients transplanted for alcoholic liver disease (ALD). Data are limited on the impact of structured management of the alcohol problem on the risk of recidivism following transplantation in ALD. MATERIAL AND METHODS: A total of 103 ALD patients were compared with a control group of patients with non-alcoholic liver disease (NALD). The recidivism rates for ALD patients transplanted between 1988 and 1997 as well as after 1998 (institution of structured management) were compared. RESULTS: The median follow-up was 31 (6-60) months in the ALD group and 37 (12-63) months in the control group (NS). The overall survival rates at 1- and 5 years were, respectively, 81% and 69% for the ALD group and 87% and 83% for the non-alcoholic group. The proportion of patients with Child-Pugh C (75%) was higher in ALD patients than in NALD patients (44%) (p<0.01). Thirty-two (33%) ALD patients resumed taking some alcohol after transplantation; 17 patients (18%) were heavy drinkers. A multivariate analysis showed that: sex, age, marital and employment status, benzodiazepine use and a history of illicit drug abuse did not predict the risk of alcohol relapse post-Tx. Nineteen out of 40 (48%) patients transplanted before the start of structured management had resumed alcohol but 13 (22%) out of 58 after this intervention (p=0.002). CONCLUSIONS: ALD is a good indication for liver transplantation, with similar results in the ALD patients. Structured management of the alcohol problem before and after transplantation is important in minimizing the risk of recidivism.
机译：目的：以前在斯堪的纳维亚国家尚未对移植酒精性肝病（ALD）的患者进行系统评价。酒精问题的结构化管理对ALD移植后再犯风险的影响有限。材料与方法：将总共103例ALD患者与对照组的非酒精性肝病（NALD）患者进行比较。比较了1988年至1997年以及1998年之后（结构化管理机构）移植的ALD患者的复发率。结果：ALD组的中位随访时间为31（6-60）个月，而对照组（NS）的中位随访时间为37（12-63）个月。 ALD组1年和5年的总生存率分别为81％和69％，非酒精组为87％和83％。 ALD患者中Child-Pugh C患者的比例（75％）高于NALD患者（44％）（p <0.01）。十二名（33％）ALD患者在移植后恢复了饮酒。 17名患者（18％）为重度饮酒者。多因素分析表明：性别，年龄，婚姻和就业状况，苯二氮卓类药物的使用以及非法药物滥用的历史并不能预测Tx后酒精复发的风险。在开始进行有组织的管理之前，有40名患者中有19名（48％）接受了酒精恢复，但58名患者中有13名（22％）在进行了这种干预之后（p = 0.002）。结论：ALD是肝移植的良好指征，在ALD患者中具有相似的结果。移植前后酒精问题的结构化管理对于最大程度地降低累犯风险非常重要。

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