Significance and clinical impact of routinely tested urinary ethyl glucuronide after liver transplantation – development of a risk score

Abstract

Alcohol abuse after liver transplantation can seriously impact graft and patient survival. However, to date, there is no defined standard procedure to identify patients consuming alcohol after liver transplantation. The aim of this study was to analyze the diagnostic value and clinical impact of routinely measured urinary ethyl glucuronide (uEtG)a metabolite of ethanolin patients after liver transplantation. Data of 362 consecutive patients after liver transplantation who visited the University Hospital of Tuebingen for outpatient follow-up were analyzed. Forty-eight patients (13%) displayed positive uEtG results. The uEtG positive group contained significantly more patients with pretransplant alcoholic liver disease. However, two thirds of the uEtG positive patients had no history of pretransplant alcoholic liver disease. Several clinical parameters were significantly associated with positive uEtG. In order to enable a more cost-effective application of uEtG in the future, a clinical risk score was developed (specificity 0.95). In conclusion, routine testing for uEtG reveals a considerable percentage of patients practicing alcohol intake after liver transplantation. Application of our proposed risk score could help focusing uEtG testing on patients at risk.

Identification of Alcohol Use Prior to Major Cancer Surgery: Timeline Follow Back Interview Compared to Four Other Markers

“…For instance, the U–EtG is a strong indicator of any amount of present drinking, [ 21 ]; thus, inclusion of persons with a detected low alcohol use would lead to false negative results in our study group. Instead, this alcohol marker could be relevant for following up during intervention aiming at complete abstinence as in the 4-week prehabilitation [ 29 ] and the 6-month period recommended prior to liver transplantation [ 30 ].…”