Transplant Trial Watch

Alcohol relapse and its predictors after liver transplantation for alcoholic liver disease: a systematic review and meta-analysis.

Chuncharunee, L., Yamashiki, N. et al. (2019).

BMC Gastroenterology [record in progress].


Aims
This study aimed to evaluate alcohol relapse rate and its predictors after liver transplantation (LT).

Interventions
The Medline and SCOPUS via Pubmed and Scopus search engines were searched to identify studies published up to 31 March 2018.

Participants
A total of 127 studies were included. Of these studies, 90 reported the proportion of alcohol relapse and 37 assessed risk factors of alcohol relapse.

Outcomes
The outcome of interest was alcohol relapse and heavy alcohol relapse in patients who underwent LT for alcoholic liver disease.

Follow-up
48.4 ± 24.7 months.

CET Conclusions
The aim of the systematic review with meta-analysis was to review the prevalence of alcohol relapse after liver transplantation and to explore factors associated with alcohol relapse. The review was prospectively registered with PROSPERO. Medline and Scopus were searched and two reviewers independently screened titles and abstracts and identified studies for inclusion. Data extraction and quality assessment was also done by two reviewers. The review included 90 studies that reported on alcohol relapse and 37 studies that reported risk factor alcohol relapse. The pooled alcohol relapse rate was 22% (95% CI: 19-25%, heterogeneity 91%) and the heavy alcohol relapse rate (alcohol relapse that was associated with significant harm) was 14% (95% CI: 12-16%, heterogeneity 85%). Factors significantly associated with alcohol relapse after liver transplantation were psychiatric comorbidities, pre-transplant abstinence of less than 6 months, being unmarried and smoking. Subgroup analyses were conducted to explore potential sources of heterogeneity.

Quality notes
SR - QA not necessary.

Trial registration
PROSPERO-CRD42017052659

Funding source
Industry funded