Psychiatric outcome in alcoholic liver transplant patients

We investigated drinking behaviour and psychiatric outcome of patients with alcoholic liver disease after liver transplantation, to help assess the advisability of the procedure in these patients. English-speaking patients (n = 20) transplanted for alcoholic liver disease and informants, and patients transplanted for non-alcoholic liver disease (n = 54), were assessed by semi-structured interviews and standardized questionnaires 1-6 years following transplantation. All alcoholics were abstinent for several months after transplantation, but only one patient remained totally abstinent. Sixteen of the 20 alcoholics later returned to regular drinking; the mean daily alcohol consumption was 3.5 units. Forty percent of the group were drinking above the recommended safe levels for the general population and over 50% were 'binge' drinking intermittently. The alcoholic liver transplant patients did not have higher levels of psychiatric or physical morbidity than controls. Patients with alcoholic liver disease return to drinking after a period of abstinence following liver transplantation, although at lower levels than before. Their vulnerability to alcohol abuse is not explained by higher levels of physical or psychiatric morbidity.