| Abstract [eng] |
Study aim. To review and systematize the information presented in the scientific literature regarding the frequency of alcohol abuse relapse, relapse assessment models, risk factors, and prevention strategies for patients suffering from alcoholic liver disease and awaiting liver transplantation. Research methods. A systematic review of scientific literature was conducted using the PubMed, UpToDate, and Google Scholar databases. Scientific literature not older than 10 years was used, including: systematic reviews, meta-analyses, literature reviews, statistical publications, retrospective studies, and the latest practical clinical guidelines. Results and conclusions. Harmful alcohol consumption is the main cause of liver cirrhosis in Western countries, therefore, the number of patients suffering from alcoholic liver disease (ALD) who require liver transplantation (LTx) is growing annually. However, alcohol consumption after LTx occurs in up to 30% of cases. Patients who resume alcohol consumption have a significantly higher risk of developing graft steatosis, steatohepatitis, alcoholic hepatitis, or cirrhosis compared to those who maintain abstinence. Also, the 10-year mortality risk of patients who experienced alcohol relapse is more than 3 times higher compared to patients maintaining abstinence. To select patients for liver transplantation with the lowest risk of alcohol relapse, it is important to assess proven risk factors that increase alcohol relapse: comorbid psychiatric disorder, abstinence shorter than 6 months before liver transplantation, social isolation, smoking, and poor cooperation with physicians. Analysis of these factors and special risk assessment calculators (e.g., HRAR, MAPS, AUDIT-C, ARRA, SALT) help to select more suitable candidates for LTx, especially in cases where early transplantation, without 6 months of abstinence, is required. |
