Impact of tobacco and alcohol consumption in patients registered on waiting list on early morbidity following liver transplantation

Perney, Pascal; Segalas, F.; Nalpas, Bertrand; Chanques, Gérald; Rigole, H.; Duny, Yohan; Blanc, F; Jaber, Samir; Pageaux, Georges‐Philippe

doi:10.1016/j.clinre.2013.01.009

Cited by 9 publications

(12 citation statements)

References 35 publications

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“…After de-duplication, 5644 articles were left for screening according to the titles and abstracts, with 78 records determined as potentially eligible. The full texts and data integrity of these studies were reviewed, and 8 articles and 3 additional articles retrieved through the references of the above were included in this meta-analysis (Fig 1)[2,3,5,20–27]. The characteristics of the included studies are presented in Table 5.…”

Section: Resultsmentioning

confidence: 99%

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Impact of cigarette smoking on early complications after liver transplantation: A single-center experience and a meta-analysis

Li¹,

Wang²,

Ma³

et al. 2017

PLoS ONE

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BackgroundWhile studies have shown that cigarette smoking has negative implications on the long-term outcome following liver transplantation, its role in early complications is inconclusive.MethodsThe clinical data of 162 consecutive adult patients who underwent elective liver transplantation from January, 2012 to March, 2016 were analyzed. Patients were defined as active smokers, ex-smokers, or non-smokers on the basis of documentation at the time of liver transplantation. The overall complications following liver transplantation were expressed as the comprehensive complication index (CCI). The specific complications such as the incidence of hepatic artery thrombosis, biliary complications, acute kidney injury were also assessed. A meta-analysis was carried out based on results from the present study and 11 published studies.ResultsWe found that cigarette smoking was not associated with higher CCI scores and smokers did not have a higher risk for developing hepatic artery thrombosis, biliary complications, acute kidney injury after liver transplantation. Meta-analysis confirmed the null association between cigarette smoking and an increased incidence of hepatic artery thrombosis or biliary complications in liver transplant recipients. However, the pooled results showed a significantly higher risk of cardiovascular diseases and de-novo malignancies in smokers following liver transplantation.ConclusionThere is not enough evidence supporting an association between cigarette smoking and early mortality and morbidity after liver transplantation. However, smokers should still be encouraged to quit before and after liver transplantation due to the long-term health benefits of smoking cessation.

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Section: Resultsmentioning

confidence: 99%

“…These results are in line with the results of several previous studies. Perney et al found that smokers did not exhibit more post-LT complications than never-smokers[3]. The incidence of hepatic artery thrombosis after liver transplantation was 16.5% in smokers and 19.2% in non-smokers.…”

Section: Discussionmentioning

confidence: 99%

Impact of cigarette smoking on early complications after liver transplantation: A single-center experience and a meta-analysis

Li¹,

Wang²,

Ma³

et al. 2017

PLoS ONE

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“…Our data showed that the prevalence of lifetime tobacco use was higher in era 2 patients compared with era 1 patients (62% versus 41%). According to previous studies, approximately 60% of LT candidates reported a lifetime history of cigarette smoking with the percentage as high as 75% among ALD patients . Among the smokers, one‐third to one‐half achieved abstinence from tobacco while waiting for LT .…”

Section: Discussionmentioning

confidence: 99%

“…According to previous studies, approximately 60% of LT candidates reported a lifetime history of cigarette smoking with the percentage as high as 75% among ALD patients. (20,21) Among the smokers, one-third to one-half achieved abstinence from tobacco while waiting for LT. (20) Among our patients with a lifetime smoking history, 23% of patients in era 1 and 42% of patients in era 2 stopped smoking for more than 12 months before the evaluation. In 1 recent study, the reliability of patient self-reported tobacco use in LT candidates was high, but a 10% deception rate was identified.…”

Section: Discussionmentioning

confidence: 99%

Impact of a Prohibitive Versus Restrictive Tobacco Policy on Liver Transplant Candidate Outcomes

et al. 2019

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Tobacco use has been associated with poorer outcomes after liver transplantation (LT). Our study examined the effect on LT listing outcomes of a newly implemented policy prohibiting the use of all tobacco products compared with a prior restrictive policy. Medical records of consecutive adult patients evaluated for LT from January 2010 to July 2013 (era 1, n = 1344) and August 2013 to March 2017 (era 2, n = 1350) were reviewed. The proportion of LT candidates listed was the primary outcome. The mean age of the 2694 LT candidates was 54 ± 11 years, 60% were male, and the mean Model for End‐Stage Liver Disease (MELD) score was 15 ± 7. Although the proportion of LT candidates who were smokers was significantly higher in era 2 (33% versus 23%; P < 0.005), the proportion of smokers listed for LT remained stable (13% versus 17%; P = 0.25). However, there were more smokers excluded for ongoing tobacco use in era 2 compared with era 1 (9.6% versus 4.4%; P = 0.001). Factors independently associated with LT listing included a diagnosis of hepatocellular carcinoma, being married, private insurance, absence of psychiatry comorbidity, and absence of tobacco, marijuana, or opiate use but evaluation during era 2 was not associated with LT listing. However, the median time to listing significantly increased over time, especially in smokers (from 65 to 122 days; P = 0.001), and this trend was independently associated with evaluation during era 2, a lower MELD score, not having children, and a lower level of education (P < 0.05). In conclusion, despite an increasing incidence of active smokers being referred for LT evaluation, the proportion of smoker candidates listed for LT was unchanged after instituting our prohibitive tobacco use policy. However, the time to get on the waiting list for smokers who were eventually listed was significantly longer due to the need to achieve complete tobacco cessation.

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“…Tobacco use is associated with graft loss and higher mortality in kidney, pancreas, lung and heart transplant patients[ 33 ]. In LT patients, tobacco use is associated with an increase in the incidence of vascular complications, but this was not found in all the series[ 32 , 34 , 35 ]. De novo cancers are the second cause of late mortality after LT; during recent years, series of LT patients have shown an increase in upper aerodigestive tract, colon and kidney tumors[ 36 - 38 ].…”

Section: Psychoactive Substance Consumption After Ltmentioning

confidence: 99%

Addictive behaviors in liver transplant recipients: The real problem?

Donnadieu‐Rigole¹,

Perney²,

Ursic‐Bedoya³

et al. 2017

WJH

Self Cite

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Liver transplantation (LT) is the gold standard treatment for end-stage liver disease. Whatever the primary indication of LT, substance abuse after surgery may decrease survival rates and quality of life. Prevalence of severe alcohol relapse is between 11 and 26%, and reduces life expectancy regardless of the primary indication of LT. Many patients on waiting lists for LT are smokers and this is a major risk factor for both malignant tumors and cardiovascular events post-surgery. The aim of this review is to describe psychoactive substance consumption after LT, and to assess the impact on liver transplant recipients. This review describes data about alcohol and illicit drug use by transplant recipients and suggests guidelines for behavior management after surgery. The presence of an addiction specialist in a LT team seems to be very important.

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Impact of tobacco and alcohol consumption in patients registered on waiting list on early morbidity following liver transplantation

Cited by 9 publications

References 35 publications

Impact of cigarette smoking on early complications after liver transplantation: A single-center experience and a meta-analysis

Impact of cigarette smoking on early complications after liver transplantation: A single-center experience and a meta-analysis

Impact of a Prohibitive Versus Restrictive Tobacco Policy on Liver Transplant Candidate Outcomes

Addictive behaviors in liver transplant recipients: The real problem?

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