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Alcohol and substance abuse.
Semin Liver Dis 2009; 29(1):66-73SL

Abstract

Alcoholic liver disease is an important cause of cirrhosis, liver-associated death, and need for liver transplant. Up to 50% of recipients use some alcohol, and perhaps 10% drink addictively. Careful evaluation by an addiction medicine specialist is the best predictive instrument before transplant surgery, whereas the 6-month rule lacks sensitivity and specificity. Addictive drinking, but not minor slips, is associated with increased mortality. There is no standard therapy for alcoholism in alcoholics waiting for a transplant or for those who have undergone a transplant. Stably abstinent, methadone-maintained opiate-dependent patients should continue methadone; are generally good candidates for liver transplant; and show low relapse rates. Pre- and post-transplant smoking rates are high and cause significant morbidity and mortality. Transplant teams should encourage smoking cessation treatments. Marijuana use in liver transplant recipients is common, although risks associated with this practice are unknown.

Authors+Show Affiliations

Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA. mrl@medicine.wisc.eduNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Review

Language

eng

PubMed ID

19235660

Citation

Lucey, Michael R., and R M. Weinrieb. "Alcohol and Substance Abuse." Seminars in Liver Disease, vol. 29, no. 1, 2009, pp. 66-73.
Lucey MR, Weinrieb RM. Alcohol and substance abuse. Semin Liver Dis. 2009;29(1):66-73.
Lucey, M. R., & Weinrieb, R. M. (2009). Alcohol and substance abuse. Seminars in Liver Disease, 29(1), pp. 66-73. doi:10.1055/s-0029-1192056.
Lucey MR, Weinrieb RM. Alcohol and Substance Abuse. Semin Liver Dis. 2009;29(1):66-73. PubMed PMID: 19235660.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Alcohol and substance abuse. AU - Lucey,Michael R, AU - Weinrieb,R M, Y1 - 2009/02/23/ PY - 2009/2/25/entrez PY - 2009/2/25/pubmed PY - 2009/5/1/medline SP - 66 EP - 73 JF - Seminars in liver disease JO - Semin. Liver Dis. VL - 29 IS - 1 N2 - Alcoholic liver disease is an important cause of cirrhosis, liver-associated death, and need for liver transplant. Up to 50% of recipients use some alcohol, and perhaps 10% drink addictively. Careful evaluation by an addiction medicine specialist is the best predictive instrument before transplant surgery, whereas the 6-month rule lacks sensitivity and specificity. Addictive drinking, but not minor slips, is associated with increased mortality. There is no standard therapy for alcoholism in alcoholics waiting for a transplant or for those who have undergone a transplant. Stably abstinent, methadone-maintained opiate-dependent patients should continue methadone; are generally good candidates for liver transplant; and show low relapse rates. Pre- and post-transplant smoking rates are high and cause significant morbidity and mortality. Transplant teams should encourage smoking cessation treatments. Marijuana use in liver transplant recipients is common, although risks associated with this practice are unknown. SN - 0272-8087 UR - https://www.unboundmedicine.com/medline/citation/19235660/Alcohol_and_substance_abuse_ L2 - http://www.thieme-connect.com/DOI/DOI?10.1055/s-0029-1192056 DB - PRIME DP - Unbound Medicine ER -