Alcohol and Alcoholism Advance Access originally published online on April 24, 2006
Alcohol and Alcoholism 2006 41(4):358-363; doi:10.1093/alcalc/agl033
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REVIEW
LIVER TRANSPLANTATION FOR ALCOHOLIC LIVER DISEASE: A SYSTEMATIC REVIEW OF PSYCHOSOCIAL SELECTION CRITERIA
1 Department of Psychiatry, Queen Margaret Hospital, Fife, Scotland and 2 Psychological Medicine, Royal Infirmary of Edinburgh, Scotland
* Author to whom correspondence should be addressed at: Department of Psychiatry, Queen Margaret Hospital, Whitefield Road, Dunfermline, Fife KY12 0RG, Scotland. Tel.: +44 1383 623623 (ext. 2353); Fax: +44 1383 627044; E-mail: seonaid.mccallum{at}faht.scot.nhs.uk
(Received 13 October 2005; first review notified 8 November 2005; in revised form 15 March 2006; accepted 25 March 2006)
Aims: To examine the evidence base for psychosocial selection criteria for liver transplant candidates with alcoholic liver disease. Method: Systematic review using three electronic databases supplemented by hand searches. Results: Out of 96 published studies, 22 were included. All but one were cohort design, most were retrospective, single centre, and small sample. Methodology varied considerably, such that meta-analysis was not feasible. Conclusions: Social stability, no close relatives with an alcohol problem, older age, no repeated alcohol-treatment failures, good compliance with medical care, no current polydrug misuse, and no co-existing severe mental disorder have all been associated with future abstinence in more studies than not, in those that examined these variables. Duration of preoperative abstinence was a poor predictor. We recommend that, if predicting future abstinence is considered necessary by transplant teams, a standardized approach is agreed and deployed amongst transplant units, then audited and reviewed.
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