Please use this identifier to cite or link to this item: http://hdl.handle.net/20.500.12857/121357
Title: Assessment of alcohol consumption in liver transplant candidates and recipients: the best combination of the tools available
Authors: Piano, Salvatore 
Marchioro, Lucio
Gola, Elisabetta 
Rosi, Silvia 
Morando, Filippo 
Cavallin, Marta 
Sticca, Antonietta 
Fasolato, Silvano 
Forza, Giovanni
Chiara Frigo, Anna
Plebani, Mario 
Zanus, Giacomo 
Cillo, Umberto 
Gatta, Angelo 
Angeli, Paolo 
Keywords Plus: CARBOHYDRATE-DEFICIENT TRANSFERRIN;URINARY ETHYL GLUCURONIDE;LONG-TERM SURVIVAL;PRIMARY-CARE;PROBLEM DRINKING;DISEASE PATIENTS;SCREENING TOOL;CIRRHOSIS;RECIDIVISM;IMMUNOASSAY
Mesh headings: Alcohol Drinking;End Stage Liver Disease;Liver Transplantation
Secondary Mesh headings: Aged;Alcoholism;Biomarkers;Ethanol;Female;Glucuronates;Humans;Male;Middle Aged;Odds Ratio;Prospective Studies;ROC Curve;Recurrence;Transferrin
Issue Date: Jul-2014
Publisher: WILEY-BLACKWELL
Journal: Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society 
Abstract: 
The detection of alcohol consumption in liver transplant candidates (LTCs) and liver transplant recipients (LTRs) is required to enable a proper assessment of transplant eligibility and early management of alcohol relapse, respectively. In this clinical setting, urinary ethyl glucuronide (uEtG), the Alcohol Use Disorders Identification Test for Alcohol Consumption (AUDIT-c), serum ethanol, urinary ethanol, carbohydrate-deficient transferrin (CDT), and other indirect markers of alcohol consumption were evaluated and compared prospectively in 121 LTCs and LTRs. Alcohol consumption was diagnosed when AUDIT-c results were positive or it was confirmed by a patient's history in response to abnormal results. Alcohol consumption was found in 30.6% of the patients. uEtG was found to be the strongest marker of alcohol consumption (odds ratio = 414.5, P < 0.001) and provided a more accurate prediction rate of alcohol consumption [area under receiving operating characteristic (ROC) curve = 0.94] than CDT (area under ROC curve = 0.63, P < 0.001) and AUDIT-c (area under ROC curve = 0.73, P < 0.001). The combination of uEtG and AUDIT-c showed higher accuracy in detecting alcohol consumption in comparison with the combination of CDT and AUDIT-c (area under ROC curve = 0.98 versus 0.80, P < 0.001). Furthermore, uEtG was the most useful marker for detecting alcohol consumption in patients with negative AUDIT-c results. In conclusion, the combination of AUDIT-c and uEtG improves the detection of alcohol consumption in LTCs and LTRs. Therefore, they should be used routinely for these patients.
URI: http://hdl.handle.net/20.500.12857/121357
ISSN: 15276465
DOI: 10.1002/lt.23881
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