Alcoholism, Alcohol; Liver, Alcohol Use Disorder
Conditions
Keywords
transplantation liver, hepatocellular carcinoma, Alcohol
Brief summary
Investigator seeks to determine wether integrating an addiction team into a liver transplantation unit improves the prognosis of patients with alcohol-related liver disease requiring liver transplantation. Our hypothesis is that patients managed by an addiction team before and after liver transplantation have less frequent alcohol relapses, thus decreasing the risk of cardiovascular complications, de novo cancer, recurrence of alcohol-related cirrhosis, and consequently increasing their overall survival.
Detailed description
In this observational, retrospective and multicentre study, investigator seek to determine the effect of integrating an addiction team into liver transplantation unit on prognosis of patients with alcohol-related liver disease requiring liver transplantation. Investigatore plan to compare patients in 2 groups, depending on whether they have received or not specific addiction care before and after transplantation. This study was conducted over a period of 15 years in three French liver transplant units.
Interventions
PROCEDURELiver transplantation
Liver transplantation
Sponsors
University Hospital, Montpellier
Study design
Observational model
COHORT
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* adult patients * who received a liver transplant between January 2000 and December 2015 for alcohol-related liver disease as a primary or secondary indication (hepatocellular carcinoma) * who survived for more than 6 months after their liver transplant.
Exclusion criteria
* association of other causes of hepatopathy: viral hepatitis B or C, hereditary hemochromatosis. * death before discharge from hospital after liver transplantation. * patient unwilling to participate to the study
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Overall survival of patients transplanted for alcoholic liver disease. | Date of last news (at least 5 years for surviving patients) | Patient time (delay between date of transplantation and date of last news) + state (alive or deceased) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Severe alcohol relapse rate | Date of last news (at least 5 years for surviving) | Number of patients with severe alcohol relapse among all transplanted patients |
| Rate of alcohol-related cirrhosis recurrence | Date of last news (at least 5 years for surviving) | Number of patients with alcohol-related cirrhosis among all transplanted patients. |
| Alcohol relapse rate | Date of last news (at least 5 years for surviving) | Number of patients with alcohol relapse among all transplanted patients. |
| Cardiovascular event rate | Date of last news (at least 5 years for surviving) | Number of patients with one or more cardiovascular events (coronary syndrome, stroke, arterial disease) among all transplant patients. |
| De novo cancer-free survival | Date of last news (at least 5 years for surviving) | Number of patients developing de novo cancer as a function of time among all transplanted patients |
| Rate of development of cardiovascular risk factors | Date of last news (at least 5 years for surviving) | Number of patients developing one or more cardiovascular risk factors (hypertension, dyslipidemia, diabetes, smoking) among all transplanted patients. |
Countries
France
Outcome results
None listed