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Alcohol and Alcoholism Advance Access published online on April 24, 2006
Alcohol and Alcoholism, doi:10.1093/alcalc/agl033
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© The Author 2006. Published by Oxford University Press on behalf of the Medical Council on Alcohol. All rights reserved
Received October 13, 2005
Revised March 15, 2006
Accepted March 25, 2006

Article

LIVER TRANSPLANTATION FOR ALCOHOLIC LIVER DISEASE: A SYSTEMATIC REVIEW OF PSYCHOSOCIAL SELECTION CRITERIA

SEÒNAID MCCALLUM 1 * and GEORGE MASTERTON 2 {dagger}

1 Department of Psychiatry, Queen Margaret Hospital, Fife, Scotland
2 Psychological Medicine, Royal Infirmary of Edinburgh, Scotland

* To whom correspondence should be addressed.
SEÒNAID MCCALLUM, E-mail: seonaid.mccallum{at}faht.scot.nhs.uk


  Abstract

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.

{dagger}Declaration of interest. G.M. has clinical sessions funded by the Scottish Liver Transplant Unit.
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