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A review of behavioral alcohol interventions for transplant candidates and recipients with alcohol‐related liver disease
Author(s) -
Schlagintweit Hera E.,
Lynch MarieJosée,
Hendershot Christian S.
Publication year - 2019
Publication title -
american journal of transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.89
H-Index - 188
eISSN - 1600-6143
pISSN - 1600-6135
DOI - 10.1111/ajt.15569
Subject(s) - medicine , psychological intervention , abstinence , psychosocial , context (archaeology) , alcoholic liver disease , liver transplantation , alcohol use disorder , transplantation , liver disease , observational study , intensive care medicine , relapse prevention , psychiatry , alcohol , cirrhosis , paleontology , chemistry , biology , biochemistry
Alcohol‐related liver disease ( ALD ) is a common indication for liver transplantation. Reflecting growing consensus that early transplant (ie, prior to sustained abstinence) can be a viable option for acute alcoholic hepatitis, access to liver transplantation for ALD patients has increased. Prevention of alcohol relapse is critical to pretransplant stabilization and posttransplant survival. Behavioral interventions are a fundamental component of alcohol use disorder treatment, but have rarely been studied in the transplant context. This scoping review summarizes published reports of behavioral and psychosocial alcohol interventions conducted with ALD patients who were liver transplant candidates and/or recipients. A structured review identified 11 eligible reports (3 original research studies, 8 descriptive papers). Intervention characteristics and clinical outcomes were summarized. Interventions varied significantly in orientation, content, delivery format, and timing/duration. Observational findings illustrate the importance of situating alcohol interventions within a multidisciplinary treatment context, and suggest the potential efficacy of cognitive‐behavioral and motivational enhancement interventions. However, given extremely limited research evaluating behavioral alcohol interventions among ALD patients, the efficacy of behavioral interventions for pre‐ and posttransplant alcohol relapse remains to be established.