scholarly journals Psychosocial characteristics of alcoholic and non-alcoholic liver disease recipient candidates in liver transplantation: a prospective observational study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Masato Shizuku ◽  
Hiroyuki Kimura ◽  
Hideya Kamei ◽  
Shinichi Kishi ◽  
Tatsuya Tokura ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Liver Disease ◽  
Observational Study ◽  
Alcoholic Liver Disease ◽  
Prospective Observational Study ◽  
Short Form ◽  
Depression Scale ◽  
Preoperative Period ◽  
Psychosocial Characteristics ◽  
Significant Difference

Abstract Background There are long-standing controversies about the transplant indications for alcoholic liver disease (ALD), because of the recognition that ALD is fundamentally self-inflicted. However, it is unclear whether psychosocial characteristics of ALD are different from that of non-alcoholic liver disease (NALD) in the selection of liver transplantation (LT) recipients. We aimed to clarify the psychosocial characteristics of ALD recipients (ALD-R)/ALD recipient candidates (ALD-RC) and NALD recipients (NALD-R)/ NALD recipient candidates (NALD-RC). Methods From 2011 to 2019, 75 patients were enrolled in this prospective observational study (ALD-RC, n = 19; NALD-RC, n = 56), LT were carried out as follow; ALD-R, n = 6; NALD-R, n = 52. We evaluated psychosocial characteristics in the preoperative period and 3, 12 months after LT (ALD-R, n = 3/3; NALD-R, n = 28/25). The following scales were used to evaluate psychosocial characteristics: Visual Analogue Scale, Alcohol Use Disorders Identification Test, Hospital Anxiety and Depression Scale, Beck Depression Inventory, Brief Evaluation of Medication Influences and Beliefs, Social Support Questionnaire (SSQ), Temperament and Character Inventory, Parental Bonding Instrument (PBI), the Short Form Health Survey (SF-36). Results When evaluating on the basis of abstinence rule, a comparison of ALD-RC and NALD-RC in the preoperative period identified similar patterns of psychosocial characteristics, except that the NALD-RC scored higher on the PBI item “overprotection from mother” (P < 0.05). The only significant difference between ALD-R and NALD-R after liver transplantation was in SSQ scores at 3 months. Conclusion The psychosocial characteristics of ALD-RC and NALD-RC may be similar when evaluated on the basis of Japan’s abstinence rule. This result also imply that the psychosocial characteristics of ALD-RC may differ from the previously reported psychosocial characteristics of alcohol dependent patients. These findings have the potential to provide helpful information for the evaluation of ALD-RC.

scholarly journals Psychosocial characteristics of alcoholic and non-alcoholic liver disease recipient candidates in liver transplantation: A prospective observational study

2021 ◽  
Author(s):  
Masato Shizuku ◽  
hiroyuki kimura ◽  
Hideya Kamei ◽  
Shinichi Kishi ◽  
Tatsuya Tokura ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Liver Disease ◽  
Observational Study ◽  
Alcoholic Liver Disease ◽  
Prospective Observational Study ◽  
Short Form ◽  
Psychosocial Aspects ◽  
Preoperative Period ◽  
Psychosocial Characteristics ◽  
Significant Difference

Abstract Background/AimThere are long-standing controversies about the transplant indications for alcoholic liver disease (ALD), because of the recognition that ALD is fundamentally self-inflicted. However, it is unclear whether stigmatization of ALD based on psychosocial aspects is warranted in the selection of liver transplantation (LT) recipients. We aimed to clarify the psychosocial characteristics of ALD recipients (ALD-R)/ALD recipient candidates (ALD-RC) and non-ALD recipients (NALD-R)/non-ALD recipient candidates (NALD-RC).MethodsFrom 2011 to 2019, 75 patients were enrolled in this prospective observational study (ALD-RC, n = 19; NALD-RC, n = 56), LT were carried out as follow; ALD-R, n=6; NALD-R, n=52. We evaluated psychosocial characteristics in the preoperative period and 3, 12 months after LT (ALD-R, n = 3/3; NALD-R, n = 28/25). The following scales were used to evaluate psychosocial characteristics: Visual Analogue Scale, Alcohol Use Disorders Identification Test, Hospital Anxiety and Depression Scale, Beck Depression Inventory, Brief Evaluation of Medication Influences and Beliefs, Social Support Questionnaire (SSQ), Temperament and Character Inventory, Parental Bonding Instrument (PBI), the Short Form Health Survey (SF-36).ResultsA comparison of ALD-RC and NALD-RC in the preoperative period identified similar patterns of psychosocial characteristics, except that the NALD-RC scored higher on the PBI item “overprotection from mother” (P < 0.05). The only significant difference between ALD-R and NALD-R after liver transplantation was in SSQ scores at 3 months. ConclusionThe psychosocial characteristics of ALD-RC and NALD-RC were similar. Therefore, stigmatization of ALD-RC based on psychosocial aspects is unwarranted and appropriate evaluation is needed.

scholarly journals Changes in perioperative hemoglobin and hematocrit in patients undergoing total knee arthroplasty: a prospective observational study of optimal timing of measurement

2020 ◽  
Vol 48 (11) ◽  
pp. 030006052096930
Author(s):  
Chenrong Ke ◽  
Naifeng Tian ◽  
Xiumeng Zhang ◽  
Mochuan Chen
Keyword(s):  
Total Knee Arthroplasty ◽  
Observational Study ◽  
Knee Arthroplasty ◽  
Prospective Observational Study ◽  
Optimal Timing ◽  
Preoperative Period ◽  
Hidden Blood Loss ◽  
Significant Difference ◽  
Total Knee ◽  
Hb Concentration

Objective This study was performed to depict the patterns of change in the perioperative hemoglobin (Hb) concentration and hematocrit (Hct) and to identify the optimal timing of Hb and Hct measurement in patients undergoing total knee arthroplasty (TKA). Methods This prospective observational study involved 302 consecutive patients who underwent TKA. The patients were kept in hospital for 1 full week postoperatively. Hb and Hct measurements were performed preoperatively and on days 1 to 7 postoperatively and then during clinic visits at 1, 3, and 6 months postoperatively. Results The Hb concentration and Hct decreased during the first few days postoperatively and reached a nadir on postoperative day 4 and 3, respectively; they then recovered in the following days. Significant differences in the Hb concentration and Hct were detected between the preoperative period and day 1, between days 1 and 2, between days 2 and 3, between day 7 and 1 month, and between 1 and 3 months. A significant difference in the Hct was also detected between 3 and 6 months. Conclusion The optimal timing of Hb and Hct measurement is on postoperative day 3 or 4. This timing accurately reflects ongoing hidden blood loss to better guide blood transfusions.

scholarly journals Characteristics of Psychosocial Factors in Liver Transplantation Candidates with Alcoholic Liver Disease before Transplantation: A Retrospective Study in a Single Center in Taiwan

2020 ◽  
Vol 17 (22) ◽  
pp. 8696
Author(s):  
Yu-Ming Chen ◽  
Tien-Wei Yu ◽  
Chih-Chi Wang ◽  
Kuang-Tzu Huang ◽  
Li-Wen Hsu ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Liver Disease ◽  
Alcohol Use ◽  
Family Functioning ◽  
Alcoholic Liver Disease ◽  
Rating Scale ◽  
Depression Scale ◽  
Hamilton Depression Rating Scale ◽  
Alcohol Abstinence ◽  
Abstinence Period

Liver transplantation (LT) is an essential treatment for end-stage alcoholic liver disease (ALD). The patients’ psychosocial condition plays a vital role in post-transplantation prognosis. A survey of the candidates’ psychosocial wellbeing is necessary before LT. This study aims to investigate the psychosocial characteristics, including the depression degree, family function, alcohol use duration, and alcohol abstinence period, of LT candidates with ALD. In addition, 451 candidates for LT due to ALD were enrolled. They received psychosocial evaluations, including depression scale (Hamilton depression rating scale) and family functioning assessment (adaptability, partnership, growth, affection, resolve (APGAR) index). The test scores were analyzed according to age, alcohol use duration, and alcohol abstinence period. The Hamilton depression rating scale (HAM-D) score and the family APGAR index score differentiated significantly according to the age, alcohol use duration, and abstinence period of the LT candidates. The patients with shorter alcohol use duration tended to have more severe depressive symptoms and poorer family support. The younger patients showed a significantly shorter abstinence period, more severe depression, and poorer family functioning than older patients. The younger ALD patients and patients with shorter alcohol use duration showed an increased severity of depression before transplantation. They need more mental health care over time.

scholarly journals A prospective observational study on prescribing patterns of drugs used in alcoholic liver disease patients at tertiary care teaching hospital

2017 ◽  
Vol 6 (6) ◽  
pp. 1386
Author(s):  
Zeebaish S. ◽  
Hemalatha P. ◽  
Eswari P. V. S. N. ◽  
Kodandaraman T. ◽  
Lakshmi P. ◽  
...  
Keyword(s):  
Liver Disease ◽  
Observational Study ◽  
Alcoholic Liver Disease ◽  
Prospective Observational Study ◽  
Tertiary Care ◽  
Specific Treatment ◽  
General Medicine ◽  
Prescribing Patterns ◽  
Informed Consent Form ◽  
The Right

Background: Rational drug prescribing can be defined as appropriate drugs prescribed in the right dose, at correct time intervals and for a sufficient duration. Alcoholic Liver Disease (ALD) and its complications are the principle cause for morbidity and mortality rate and accounts for elevated social and economic costs. The drug use will be a challenge for the physicians as there was no specific treatment for ALD, and decisions regarding treatment are critically depends on the symptoms and complications.Methods: A uni-centric prospective (observational) study was conducted for a period of 6months, to evaluate the current prescribing patterns used in treating ALD. All the patients admitted with diagnosis of ALD in General medicine department, both male and female medical wards were included in the study. General medicine outpatient department, special population such as pregnancy and psychiatry, patients below 18years and those who are not willing to sign in informed consent form was excluded from the study.Results: Number of males (98.02%) between age group 31-40years (29.6%) was more prone when compared to females (1.77%). Portal hypertension (30.35%) followed by jaundice (11.30%) and Ascites (10.71%) were frequently observed complications associated co-morbidities with ALD. WHO prescribing indicators showed deviation from there standard reference values. Diuretics (15.73%), antibiotics (13.14%), vitamin supplements (11.11%) and antacids (10.13%) categories were the most commonly prescribed for patients. The drugs prescribed from NLEM-2015 (82.11%) shows deviation from standard values.Conclusions: Futhermore, multi-centered studies should be conducted to draw best results on prescribing patterns of ALD in India.

scholarly journals Phosphatidylethanol for Monitoring Alcohol Use in Liver Transplant Candidates: An Observational Study

2020 ◽  
Vol 9 (9) ◽  
pp. 3060 ◽  
Author(s):  
Pablo Barrio ◽  
Antoni Gual ◽  
Anna Lligoña ◽  
Lidia Teixidor ◽  
Wolfgang Weinmann ◽  
...  
Keyword(s):  
Mass Spectrometry ◽  
Liver Transplantation ◽  
Liver Disease ◽  
Alcohol Use ◽  
Observational Study ◽  
Alcoholic Liver Disease ◽  
False Negative ◽  
Complex Process ◽  
Self Reports ◽  
Transplant Candidates

Liver transplantation remains an essential procedure for many patients suffering from alcoholic liver disease. Alcohol use monitoring remains paramount all through the stages of this complex process. Direct alcohol biomarkers, with improved specificity and sensibility, should replace traditional indirect markers. Phosphatidylethanol (PEth) has been recently tested in alcoholic liver disease patients, but more evidence is needed, especially in comparison with other direct biomarkers. We conducted an observational study among patients awaiting liver transplantation. We analyzed Peth in blood, ethylglucuronide (EtG) in hair and urine and ethylsulphate (EtS) in urine, using mass spectrometry methods. In addition, transaminases, and self-reports were analyzed. A total of 50 patients were included (84% men, mean age 59 years (SD = 6)). 18 patients (36%) screened positive for any marker. Self-reports were positive in 3 patients. EtS was the biomarker with more positive screens. It also was the most frequently exclusive biomarker, screening positive in 7 patients who were negative for all other biomarkers. PEth was positive in 5 patients, being the only positive biomarker in 2 patients. It showed a false negative in a patient admitting alcohol use the previous week and screening positive for EtG and EtS. Hair EtG was positive in 3 patients who had negative Peth, EtG. EtG did not provide any exclusive positive result.A combination of biomarkers seems to be the best option to fully ascertain abstinence in this population. Our study suggest EtS might also play a significant role.

scholarly journals Uric Acid as a Predictor for Early Allograft Dysfunction after Living Donor Liver Transplantation: A Prospective Observational Study

2021 ◽  
Vol 10 (12) ◽  
pp. 2729
Author(s):  
Li-Min Hu ◽  
Hsin-I Tsai ◽  
Chao-Wei Lee ◽  
Hui-Ming Chen ◽  
Wei-Chen Lee ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Uric Acid ◽  
Observational Study ◽  
Living Donor ◽  
Living Donor Liver Transplantation ◽  
Prospective Observational Study ◽  
Donor Liver ◽  
Donor Liver Transplantation ◽  
Allograft Dysfunction ◽  
Early Allograft Dysfunction

Early allograft dysfunction (EAD) is a postoperative complication that may cause graft failure and mortality after liver transplantation. The objective of this study was to examine whether the preoperative serum uric acid (SUA) level may predict EAD. We performed a prospective observational study, including 61 donor/recipient pairs who underwent living donor liver transplantation (LDLT). In the univariate and multivariate analysis, SUA ≤4.4 mg/dL was related to a five-fold (odds ratio (OR): 5.16, 95% confidence interval (CI): 1.41–18.83; OR: 5.39, 95% CI: 1.29–22.49, respectively) increased risk for EAD. A lower preoperative SUA was related to a higher incidence of and risk for EAD. Our study provides a new predictor for evaluating EAD and may exert a protective effect against EAD development.

Patient with Hepatitis B and Alcoholic Liver Disease Before and After Liver Transplantation

2009 ◽  
Vol 29 (02) ◽  
pp. 233-237
Author(s):  
Stephen Ward ◽  
Charissa Chang ◽  
Lan Peng ◽  
Lawrence Liu
Keyword(s):  
Liver Transplantation ◽  
Liver Disease ◽  
Hepatitis B ◽  
Alcoholic Liver Disease ◽  
Before And After
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