*Purpose: The number of patients requiring liver transplants due to Hepatitis C Virus is declining due to the new treatment options, and the growing number of adult patients requiring liver transplantation are alcoholic hepatitis and cirrhsosis. This population is often a difficult one to transplant, depending on the amount of time they have abstinent from alcohol, some having no time and needing a transplant immediately, or they will die.

*Methods: At Montefiore we decide as a Multidisciplinary Team if a patient is a candidate for a solid organ liver transplant. We recently initiated IM Naltrexone 380 mg monthly administered in our clinic, to our alcoholic hepatitis/cirrhotic patients post transplant to aide in prevention of relpase. In the immediate post operative period patients cannot enroll in inpatient rehabilitation due to frequent doctor visits and hospital readmissions. In this critical time pharmaceutical treatment can greatly aide in abstinence along with therapy.

*Results: We have enrolled 10 patients in our Naltrexone Im post liver transplant for alcholic hepatitis/cirrhosis if they had either less than 6 months of abstinence. Of those 10 patients 3 relapses and 2 were able to again abstain and 1 is still drinking. We added 1 patient post tarnsplant who had been drinking and stopped once pharmacotherpay was initiated. Of all of our alcoholic patients we transplanted we estimated ~ 50% have drank post transplant without pharmacologic intervention.

*Conclusions: By adding a pharmacologic intervention, in this case monthly IM injections of 380 mg of IM naltrexone we were able to decrease our patients rates of relapse from 50% to 30%. This should be considered as a new standard of care for patients transplanted for alcoholic heptatitis/cirrhosis with less than 6 months of sobriety or if they relpase after transplant.

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