Y. Liang1, L. DeGregorio1, M. MacConmara1, C. Hwang1 1University Of Texas Southwestern Medical Center,Department Of Surgery, Division Of Surgical Transplantation,Dallas, TX, USA
Introduction: Although liver transplantation has become standard therapy for cirrhosis due to alcohol use, it remains a controversial practice for treating severe alcoholic hepatitis. The Stanford Integrated Psychosocial Assessment Tool for Transplant (SIPAT) is a tool used in the psychosocial assessment of potential liver transplant recipients, where a lower score is correlated with improving candidacy for transplantation. We sought to examine medication compliance in relation to SIPAT score in a small cohort of liver transplant recipients who were transplanted for severe alcoholic hepatitis.
Methods: A retrospective study was conducted between January 2015 to August 2019 to identify recipients who underwent orthotopic liver transplantation (OLT) for either alcohol-related cirrhosis or severe alcoholic hepatitis. SIPAT scores and serum tacrolimus levels were extracted from electronic medical records. The standard deviation in serum tacrolimus levels at one-, three-, and six-months were calculated.
Results: Nine patients with severe alcoholic hepatitis received orthotopic liver transplantation. Three of the nine patients did not receive a SIPAT score due to urgent evaluation. Compliance was assessed by variation in tacrolimus levels. Compared to alcohol-related cirrhosis, recipients with alcoholic hepatitis had higher median and mean SIPAT scores but had lower median and mean variability (in SD, ng/mL) in tacrolimus levels at one-, three-, and six-months post-transplant. Variability in tacrolimus levels in those who did not receive a SIPAT evaluation were similar to those of alcohol-related cirrhosis.
Conclusion: Despite the reservation surrounding patients with alcoholic hepatitis receiving a liver transplantation, this small, retrospective cohort study from a single institution showed that their compliance during six-month follow up has been stable despite their higher SIPAT scores at time of evaluation.
