Abstract | OBJECTIVES: MATERIALS AND METHODS: RESULTS: Based on the univariate analysis using Cox proportional hazards model, duration of alcohol abstinence 6 months (HR 3.74; P = .011, 95% CI: 1.36-10.3), non-alcohol related criminal history (HR 3.18; P = .032, 95% CI: 1.1-9.15), support from immediate family (HR 0.24; P = .0061, 95% CI: 0.09-0.67), and active smoking at the time of liver transplant (HR 2.74; P = .041, 95% CI: 1-7.53) were identified as significant predictors for recidivism. Older patients had less likelihood of alcohol relapse (HR 0.91; P = .0014, 95% CI: 0.87-0.97) on univariate model. In multivariate model older patients (HR 0.91; P = .004, 95% CI: 0.86-0.97) and patients who have immediate family support (HR 0.27; P = .012, 95% CI: 0.10-0.76) predicated against recidivism. Suggestive features of alcoholic hepatitis on liver explant did not predict recidivism or long-term survival. One-, three-, and five-year patient survival rates estimated by Kaplan-Meier survival model in the recipients that remained abstinent were 95%, 87%, and 80%, compared with 87%, 49%, and 49% for the recipients with recidivism (P = .001). CONCLUSIONS: Recidivism is associated with earlier death after liver transplant. Older recipients and patients with immediate family support are less likely to have alcohol relapse, and have better long-term survival.
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Authors | Sanjaya K Satapathy, James D Eason, Satheesh Nair, Oleksandra Dryn, Pamela B Sylvestre, Mehmet Kocak, Jason M Vanatta |
Journal | Experimental and clinical transplantation : official journal of the Middle East Society for Organ Transplantation
(Exp Clin Transplant)
Vol. 13
Issue 5
Pg. 430-40
(Oct 2015)
ISSN: 2146-8427 [Electronic] Turkey |
PMID | 26450466
(Publication Type: Journal Article)
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Topics |
- Age Factors
- Alcohol Abstinence
- Disease-Free Survival
- Family Relations
- Female
- Humans
- Kaplan-Meier Estimate
- Liver Diseases, Alcoholic
(diagnosis, epidemiology, psychology, surgery)
- Liver Transplantation
(adverse effects, mortality)
- Male
- Middle Aged
- Multivariate Analysis
- Patient Selection
- Proportional Hazards Models
- Recurrence
- Retrospective Studies
- Risk Factors
- Social Support
- Time Factors
- Treatment Outcome
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