Probabilities of relapse and abstinence among liver transplant recipients

✍ Scribed by Thomas P. Beresford

• Publisher: John Wiley and Sons
• Year: 2006
• Tongue: English
• Weight: 54 KB
• Volume: 12
• Category: Article
• ISSN: 1527-6465
• DOI: 10.1002/lt.20752

✦ Synopsis

Andrea DiMartini and her colleagues have provided prospectively gathered data on the course of alcohol use among liver transplant recipients during the first 5 years of postgraft living. Having worked with the difficult issue of alcohol use disorders and liver transplantation for a number of years now, I know the results of her study will be viewed in many ways.

One frame of reference-that of the most exacting utilitarianism untroubled by the vicissitudes of human experience-might conclude, "There is nothing here that I can use. Alcohol-dependent people are likely to drink heavily: no surprise there. The investigators found no empirical cut point for pretransplant abstinence that we can use in selection: again, no help. And 1 in 4 alcoholic graft recipients were back drinking heavily within 5 years. How can I explain that when I'm talking with a donor parent of a child killed by a drunk driver?" This stance pays no attention to Sir William Osler's conclusion that "Medicine is a science of uncertainty and an art of probability." 1 An opposite theoretical stance-one holding that technical idealism will save us all-might view Dr. DiMartini's results and say, "Wow! Three out of 5 alcoholics didn't drink any alcohol in 5 years, and 3 out of 4 never returned to pathological drinking in that time!