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Employment and alcohol use after liver transplantation for alcoholic and nonalcoholic liver disease: A systematic review
Author(s) -
Bravata Dena M.,
Olkin Ingram,
Barnato Amber E.,
Keeffe Emmet B.,
Owens Douglas K.
Publication year - 2001
Publication title -
liver transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.814
H-Index - 150
eISSN - 1527-6473
pISSN - 1527-6465
DOI - 10.1053/jlts.2001.22326
Subject(s) - alcoholic liver disease , medicine , liver transplantation , abstinence , odds ratio , liver disease , alcohol , confidence interval , transplantation , gastroenterology , cirrhosis , psychiatry , biology , biochemistry
The purpose of the study is to evaluate patterns of employment and alcohol use among liver transplant recipients with alcoholic (ALD) and nonalcoholic liver disease (non‐ALD). MEDLINE, EMBASE, and bibliographic searches identified 5,505 potentially relevant articles published between January 1966 and October 1998. Eighty‐two studies reporting data on 5,020 transplant recipients met our inclusion criteria. Pre—orthotopic liver transplantation (OLT), 29% of transplant recipients with ALD and 59% of those with non‐ALD worked versus 33% and 80% at 3 years for transplant recipients with ALD and non‐ALD, respectively ( P < .00001 for each interval). We found no difference in the proportion of transplant recipients with ALD and non‐ALD reporting early alcohol use post‐OLT: 4% versus 5% at 6 months and 17% versus 16% at 12 months. However, among post‐OLT drinkers, transplant recipients with non‐ALD were more likely to drink moderately and those with ALD to drink excessively. At 7 years post‐OLT, 32% of the patients with ALD reported using alcohol. The odds ratio for alcohol use among patients who maintained abstinence for fewer than 6 months pre‐OLT versus those who maintained abstinence for greater than 6 months was 7.8 (95% confidence interval, 4.0 to 15.3). Before OLT and at long‐term follow‐up, substantially more transplant recipients with non‐ALD than ALD were employed. The proportions of transplant recipients with ALD and non‐ALD reporting alcohol use did not differ, although those with ALD tended to consume greater quantities.