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Authors Fleming MF, Smith MJ, Oslakovic E, Lucey MR, Vue JX, Al-Saden P, Levitsky J
Author Profile(s)
Journal Alcohol. Clin. Exp. Res.
Publish Date 2017 Feb 14
PubMed ID 28196282
Abstract

Alcohol dependent liver transplantation (LT) patients who resume alcohol are at risk for a number of alcohol related problems including liver injury and liver failure. Post LT patients are strongly advised to remain abstinent. However, we don’t know how well this population complies due to a lack of valid methods (self-report and/or biomarkers) to identify alcohol use. Studies suggest as many as 50% resume alcohol use within 5 years. Phosphatidylethanol (PEth) is a new cell-membrane phospholipid biomarker to identify alcohol use in the past 28 days. This prospective study followed 213 LT recipients at two US liver transplant centers.Sample included 213 LT subjects. 70.9% (n=151/213) had a history of alcohol dependence prior to transplantation and 29.1% (n=62/213) served as non-alcohol dependent controls. Subjects participated in face-to-face interviews to assess alcohol use using a 30-day calendar. The protocol called for collecting blood samples at baseline, 6- and 12-month follow-up.70% (149/213) who reported no alcohol use had consistently negative PEth levels (<8ng/ml). A total of 26.4% (57/213), 44 alcohol-dependent patients and 13 controls, had a positive PEth test of >8 ng/ml either at baseline and/or during the follow-up period. 23.8% (n=36/151) alcohol-dependent subjects and 16.1% (n=10/62) controls reported no alcohol use but had at least one positive PEth test. Of the 11.2% (24/213) post LT subjects who reported recent alcohol use over half (11/24) had a positive PEth. The 13 self-reported alcohol users with a negative PEth level reported insufficient drinking to trigger PEth formation.Adoption of PEth as part of routine post-transplant care of LT recipients will enable early identification of patients at risk of alcohol use and facilitate abstinence in patients with a history of alcohol dependence and alcohol related liver damage. This article is protected by copyright. All rights reserved.

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