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Acta Med Port. 2011 Dec;24 Suppl 4:835-44. Epub 2011 Dec 31.

[Alcohol liver disease patients and liver transplantation: a psychosocial approach].

[Article in Portuguese]

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Serviço de Psiquiatria, Faculdade de Medicina de Lisboa, Unidade Transplantação, Hospital Curry Cabral, Lisboa, Portugal.


One of the most common indications for Liver transplantation is Alcohol Liver Disease (ALD). Transplant recipients with ALD have a similar prognosis in terms of medical evolution and quality of life to those with other liver diseases. ALD is present when alcoholism (alcohol dependence /abuse) or heavy drinking coexists with chronic/acute liver disease. In the present article difficulties in establishing this diagnosis are debated. The main predictors of alcohol intake relapse after transplantation are: pre-transplantation abstinence (> 6m), social support, diagnosis acceptance, history of previous treatments, alcohol abuse VS dependence, Vaillant prognosis factors, good adherence (good prognosis); and family history of alcoholism, psychiatric history (psychosis, personality disorder), duration of alcoholism period, quantity of alcohol /day consumed (bad prognosis). Based in these factors we present a new evaluation scale. Diagnosis of alcohol relapse depends on the criterion used. Relapse rate is 5.6% /year. In the end of this article we discuss the different psychopharmacological and psychological methods used to treat pos-transplantation alcoholism relapse and some ethical aspects related to discrimination of patients with ALD.

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