Purpose: Liver transplant centers tend to focus primarily on duration of sobriety prior to consideration for transplantation in patients with alcoholic liver disease, with limited attention to concurrent factors.

Methods: A single center retrospective study was performed among adult liver transplant recipients with alcoholic liver disease between 2011 and 2015. Data were collected on sociodemographic variables (marital status, employment status, incarceration history, home ownership, perceived social support, and self-rated health), and alcohol and illicit drug use, pre- and post-transplant. Patients were screened for depression (PHQ-9) and generalized anxiety disorder (GAD-7). Descriptive statistics were used to provide sociodemographic, alcohol and substance use, and mental health profiles.

Results: Of 201 eligible patients, 67 participated. A majority were married (56.7%), owned their own homes (70.2%), and resided in the state where their transplant was done (80.88%). The mean age was 56 and the mean time of post-transplant follow up was 3.6 years. A majority reported that their health was either “good” (37.3%) or “very good” (28.4%). 70.2% were either retired or on disability. 33.9% reported less than 6 months of sobriety prior to transplant. While 21.2% of patients self-reported alcohol consumption post-transplant, a much smaller group (4.5%) displayed at-risk drinking. Nearly half of patient reported recreational drug use pre-transplant (e.g. cannabis: 47.8%; cocaine: 34.3%) with much lower rates in the post-transplant period. Nearly one-third of patients reported post-transplant tobacco use (29.2%). Mental health symptoms were prevalent in this sample with 22.4% endorsing moderate to severe depression and possible anxiety disorder (17.9%). Overall survival in the cohort of 201 eligible patients was 82.5%, with a median follow-up time of 2.5 years.

Conclusions: Based on self-report of participating patients, heavy alcohol use is relatively uncommon following transplant, but overall functioning remains limited in areas of work, mental health, and residual substance use post liver transplant. Survival outcomes are good, but greater attention is needed in order to address the multiple components of psychosocial burdens that tend to accompany alcoholism.

CITATION INFORMATION: Sultan S, Hodorowicz M, Powell J, Connelly M, Tuten M, Sacco P, Hutson W, Barth R, LaMattina J. Concurrent Psychosocial Variables Confound Perioperative and Postoperative Care in Liver Transplant Recipients with Alcoholic Liver Disease. Am J Transplant. 2017;17 (suppl 3).

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