AUTHOR=Belli Luca S. , Panariello Adelaide , Perricone Giovanni , Prandoni Paola , Viganò Raffaella , Mazzarelli Chiara , Becchetti Chiara , Giacalone Sara , Donvito Giovanna , Conti Sara , Cortesi Paolo A. , Roselli Elena , Monti Gianpaola , Carbone Marco , De Carlis Luciano G. , Percudani Mauro 

TITLE=Liver Transplantation in Alcohol-Associated Hepatitis. Benefits and Limitations of Psychosocial Selection and Support in Alcohol Relapse. The Experience of a Tertiary Center in Italy

JOURNAL=Transplant International

VOLUME=Volume 37 - 2024

YEAR=2025

URL=https://www.frontierspartnerships.org/journals/transplant-international/articles/10.3389/ti.2024.13451

DOI=10.3389/ti.2024.13451

ISSN=1432-2277

ABSTRACT=In patients with SAH non-responders to MT, mental illness should be assessed and treated along with the ALD..

One hundred consecutive patients with SAH from April 2016 to May 2023 were analyzed. All patients had severe AUD and were evaluated by an integrated team including psychiatrists, addiction specialists and social workers. Sixty-three patients were non-responder to MT.  Thirty (30%) were listed, of whom 25 underwent early liver transplantation (eLT) af-ter a median time of 36 days from the index episode of SAH with a median model for end-stage liver disease (MELD) score at LT of 36, whereas 33 (33%) were excluded, with psycho-social issues being the main cause of exclusion in 18 patients (54.5%). Twenty-four patients (96%) are currently alive after a median follow-up of 32 months from LT. Sixteen transplanted patients had major depression with or without anxiety, with 10 patients (33%) being treated with antidepressants post-LT. Overall, 4 patients (16%) relapsed into alcohol consumption after liver transplantation (LT), 2 of them had severe relapse (8%) and 1 died of alcohol-related liver disease (ALD) (4%). 

Psychiatric comorbidities are highly prevalent among patients with sAH and their treat-ment contributed to mitigate the risk of alcohol relapse after LT.