Impact of Integrating an Addiction Team on Post Liver Transplantation Survival for Alcohol-related Liver Disease and Its Complications.

Study Overview
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Brief Summary
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Investigator seeks to determine wether integrating an addiction team into a liver transplantation unit improves the prognosis of patients with alcohol-related liver disease requiring liver transplantation. Our hypothesis is that patients managed by an addiction team before and after liver transplantation have less frequent alcohol relapses, thus decreasing the risk of cardiovascular complications, de novo cancer, recurrence of alcohol-related cirrhosis, and consequently increasing their overall survival.

Detailed Description
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In this observational, retrospective and multicentre study, investigator seek to determine the effect of integrating an addiction team into liver transplantation unit on prognosis of patients with alcohol-related liver disease requiring liver transplantation. Investigatore plan to compare patients in 2 groups, depending on whether they have received or not specific addiction care before and after transplantation. This study was conducted over a period of 15 years in three French liver transplant units.

Official Title
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Impact of Integrating an Addiction Team on Post Liver Transplantation Survival for Alcohol-related Liver Disease and Its Complications: a Multicenter Retrospective Comparative Study.

Conditions
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Alcoholism, Alcohol Use Disorder, Alcohol; Liver

Intervention / Treatment
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* Procedure: Liver transplantation


Participation Criteria
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Eligibility Criteria
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Inclusion criteria: adult patients who received a liver transplant between January 2000 and December 2015 for alcohol-related liver disease as a primary or secondary indication (hepatocellular carcinoma) who survived for more than 6 months after their liver transplant. Exclusion criteria: association of other causes of hepatopathy: viral hepatitis B or C, hereditary hemochromatosis. death before discharge from hospital after liver transplantation. patient unwilling to participate to the study

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Transplanted patients seen by an addictionology team<br>Adult patients with alcohol-related liver disease, possibly complicated by hepatocellular carcinoma, that required liver transplantation in participating centers from January 2000 to December 2015, and seen by an addictology team before and after the transplantation. | Procedure: Liver transplantation<br>* Liver transplantation<br>|
| Transplanted patients not seen by an addictionology team<br>Adult patients with alcohol-related liver disease, possibly complicated by hepatocellular carcinoma, that required liver transplantation in participating centers from January 2000 to December 2015, and seen by an addictology team before and after the transplantation. | Procedure: Liver transplantation<br>* Liver transplantation<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Overall survival of patients transplanted for alcoholic liver disease. | Patient time (delay between date of transplantation and date of last news) + state (alive or deceased) | Date of last news (at least 5 years for surviving patients) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Alcohol relapse rate | Number of patients with alcohol relapse among all transplanted patients. | Date of last news (at least 5 years for surviving) | 
| Severe alcohol relapse rate | Number of patients with severe alcohol relapse among all transplanted patients | Date of last news (at least 5 years for surviving) | 
| Rate of alcohol-related cirrhosis recurrence | Number of patients with alcohol-related cirrhosis among all transplanted patients. | Date of last news (at least 5 years for surviving) | 
| Rate of development of cardiovascular risk factors | Number of patients developing one or more cardiovascular risk factors (hypertension, dyslipidemia, diabetes, smoking) among all transplanted patients. | Date of last news (at least 5 years for surviving) | 
| Cardiovascular event rate | Number of patients with one or more cardiovascular events (coronary syndrome, stroke, arterial disease) among all transplant patients. | Date of last news (at least 5 years for surviving) | 
| De novo cancer-free survival | Number of patients developing de novo cancer as a function of time among all transplanted patients | Date of last news (at least 5 years for surviving) | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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transplantation liver, hepatocellular carcinoma, Alcohol