Management of Alcohol-Associated liver disease and alcohol use disorder in liver transplant candidates and recipients: Challenges and opportunities.

Journal: Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society

Volume: 

Issue: 

Year of Publication: 

Affiliated Institutions:  Division of Gastroenterology and Hepatology, University of Michigan, Ann Arbor, MI. Department of Psychiatry, Columbia University Medical Center, New York, NY. Division of Gastroenterology and Hepatology, University of North Carolina, Chapel Hill, NC. Division of Gastroenterology and Hepatology, Stanford University, Stanford, CA. Division of Gastroenterology, Hepatology and Nutrition, University of Minnesota, Minneapolis, MN. Division of Gastroenterology, Hepatology and Nutrition, University of Chicago, Chicago, IL. Division of Gastroenterology and Hepatology, UMass Chan Medical School, Worcester, MA. Section of Digestive Diseases and Program in Addiction Medicine, Yale School of Medicine, New Haven, CT. Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC. Division of Gastroenterology and Hepatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA.

Abstract summary 

Alcohol-associated liver disease (ALD) poses a significant global health burden, with rising alcohol consumption and prevalence of alcohol use disorder (AUD) contributing to increased morbidity and mortality. This review examines the challenges and opportunities in the care of liver transplant (LT) candidates and recipients with AUD. Despite advancements in post-transplant patient survival, the risk of disease recurrence and alcohol relapse remains substantial. Several challenges have been identified, including (1) rising disease burden of ALD, variable transplant practices, and systemic barriers; (2) disparities in mental health therapy access and the impact on transplant; (3) variable definitions, underdiagnosis, and stigma affecting access to care; and (4) post-LT relapse, its risk factors, and consequential harm. The review focusses on the opportunities to improve AUD care for LT candidates and recipients through effective biochemical monitoring, behavioral and pharmacologic approaches, creating Centers of Excellence for post-LT AUD care, advocating for policy reforms, and ensuring insurance coverage for necessary services as essential steps toward improving patient outcomes. The review also highlights unmet needs, such as the scarcity of addiction specialists, and calls for further research on personalized behavioral treatments, digital health, and value-based care models to optimize AUD care in the LT setting.

Authors & Co-authors:  Sharma Shenoy Shroff Kwong Lim Pillai Devuni Haque Balliet Serper

Study Outcome 

Source Link: Visit source

Statistics
Citations : 
Authors :  10
Identifiers
Doi : 10.1097/LVT.0000000000000362
SSN : 1527-6473
Study Population
Male,Female
Mesh Terms
Other Terms
Study Design
Study Approach
Country of Study
Publication Country
United States