Alcohol‐associated liver disease predicts increased post‐liver transplant opioid use. Issue 12 (19th September 2022)

• Record Type: Journal Article
• Authors: Johnson‐Laghi, Krystina A.; Woo, Stephanie M.; Zafar, Zaeema; Fernandez, Stephen; Desale, Sameer; Robertazzi, Suzanne E.; Smith, Coleman I.; Thomas, Arul M.; Lalos, Alexander T.; Georgia, Sarah J.; Jenkins, Michelle L.; Faust, Thomas W.; Fishbein, Thomas M.; Satoskar, Rohit S.; Rangnekar, Amol S.; Hsu, Christine C.
• Is Part Of: Clinical transplantation. Volume 36:Issue 12(2022)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2022-09-19
• Subjects: alcoholism and substance abuse -- liver disease -- outpatient care -- patient characteristics -- risk assessment/risk stratification; Transplantation of organs, tissues, etc -- Periodicals; 617.95
• DOI: 10.1111/ctr.14811
• Languages: English
• ISSNs: 0902-0063

Abstract

Abstract: Background: Alcohol‐associated liver disease (ALD) is a rising indication for liver transplantation (LT). Prolonged opioid use after LT leads to increased graft loss and mortality. The aim is to determine if patients transplanted with a primary diagnosis of ALD had higher risk of post‐LT opioid use (p‐LTOU) compared to non‐ALD patients. Methods: This is a retrospective study of patients who underwent LT between 2015 and 2018 at Medstar Georgetown Transplant Institute. Patients with prolonged hospitalization post‐LT (>90 days), death within 90 days post‐LT, and re‐transplants were excluded. Results: Two hundred and ninety seven patients were transplanted, among 29% for indications of ALD. ALD patients were younger (52 vs. 56 years), more likely to be male (76% vs. 61%), Caucasian (71% vs. 44%), have higher MELD (28.8±8.8 vs. 25±8.8), and psychiatric disease than non‐ALD patients ( P < .05). There was no difference in pre‐LT use of opioids, tobacco, marijuana, or illicit drugs between ALD and non‐ALD patients. Pre‐LT opioid use (OR = 11.7, P < .001), ALD (OR = 2.5, P = .01), and MELD score (OR = .95, P = .02) independently predicted 90‐day p‐LTOU. Conclusions: ALD, pre‐LT opioid use, and MELD score independently predict p‐LTOU. Special attention should be paid to identify post‐LT prolonged opioid use in ALD patients.