Active Smoking Before Liver Transplantation in Patients with Alcohol Use Disorder: Risk Factors and Outcomes
Abstract
:1. Introduction
2. Materials and Methods
2.1. Participants and Procedure
2.2. Data Analysis
2.3. Ethical Issues
3. Results
3.1. Smoking Status at LT and Outcomes
3.2. Factors Associated With Active Smoking Before LT
3.3. Factors Associated With Active Smoking After LT
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Total (n = 314) | Group 1: Non-Smokers (n = 59) | Group 2: Ex-Smokers (n = 130) | Group 3: Active Smokers (n = 125) | p | |
---|---|---|---|---|---|
Male | 283 (90.1%) | 50 (17.7%) | 119 (42.0%) | 114 (40.3%) | 0.30 |
Age, Years (SD) | 55.48 (7.47) | 56.31 (7.53) | 57.50 (6.67) | 53.00 (7.59) | 0.00 |
MELD (SD) | 16.89 (6.50) | 18.05 (7.15) | 15.83 (6.03) | 17.43 (6.54) | 0.04 |
Liver-Kidney | 11 (3.6%) | 2 (18.2%) | 8 (72.7%) | 1 (9.1%) | 0.07 |
HCV | 127 (40.4%) | 17 (13.4%) | 43 (33.9%) | 67 (52.8%) | 0.00 |
HBV | 13 (4.1%) | 2 (15.4%) | 5 (38.5%) | 6 (46.2%) | 0.88 |
HCC | 130 (41.4%) | 21 (16.2%) | 58 (44.6%) | 51 (39.2%) | 0.49 |
HIV | 12 (3.8%) | 2 (16.7%) | 6 (50.0%) | 4 (33.3%) | 0.83 |
Good Family Support | 261 (86.1%) | 54 (20.7%) | 115 (44.1%) | 92 (35.2%) | 0.02 |
Unstable Family Support | 41 (13.6%) | 4 (9.8%) | 14 (34.1%) | 23 (56.1%) | 0.03 |
Living Donor | 22 (7.1%) | 4 (18.2%) | 9 (40.9%) | 9 (40.9%) | 0.99 |
Alcohol Abstinence Before LT 1–C6 Months | 60 (19.1%) | 12 (20.0%) | 21 (35.0%) | 27 (45.0%) | 0.52 |
Alcohol Abstinence Before LT 7–12 Months | 88 (28.0%) | 20 (22.7%) | 33 (37.5%) | 35 (39.8%) | 0.48 |
Alcohol Abstinence Before LT >12 Months | 166 (52.9%) | 27 (16.3%) | 76 (45.8%) | 63 (38.0%) | 0.21 |
DHD > 25 Years | 107 (34.3%) | 16 (15.0%) | 51 (47.7%) | 40 (37.4%) | 0.18 |
DHD 11–25 Years | 161 (51.6%) | 32 (19.9%) | 65 (39.8%) | 64 (40.4%) | 0.90 |
DHD < 11 Years | 44 (14.1%) | 11 (25.0%) | 12 (27.3%) | 21 (47.7%) | 0.13 |
SDU < 11 | 144 (46.3%) | 36 (25.0%) | 54 (37.5%) | 54 (37.5%) | 0.04 |
SDU 11–20 | 125 (40.2%) | 16 (12.8%) | 60 (48.0%) | 49 (39.2%) | 0.04 |
SDU > 20 | 42 (13.5%) | 7 (16.7%) | 14 (33.3%) | 21 (50.0%) | 0.35 |
0 Alcoholism Treatment | 268 (85.4%) | 49 (18.3%) | 111 (41.4%) | 108 (40.3%) | 0.83 |
1 Alcoholism Treatment | 37 (11.8%) | 9 (24.3%) | 18 (48.6%) | 10 (27.0%) | 0.23 |
2 Alcoholism Treatments | 9 (2.9%) | 1 (11.1%) | 1 (11.1%) | 7 (77.8%) | 0.05 |
HRAR Score >3 | 107 (34.4%) | 16 (15.0%) | 48 (44.9%) | 43 (40.2%) | 0.36 |
Concomitant Substance Abuse | 92 (29.3%) | 5 (5.4%) | 31 (33.7%) | 56 (60.9%) | 0.00 |
Benzodiazepines | 14 (4.5%) | 1 (7.1%) | 5 (35.7%) | 8 (57.1%) | 0.32 |
Cannabis | 49 (15.6%) | 3 (6.1%) | 17 (34.7%) | 29 (59.2%) | 0.00 |
Heroin | 28 (8.9%) | 3 (10.7%) | 11 (39.3%) | 14 (50.0%) | 0.39 |
Cocaine | 51 (16.2%) | 3 (5.9%) | 15 (29.4%) | 33 (64.7%) | 0.00 |
Other | 5 (1.6%) | 0 (0.0%) | 1 (20.0%) | 4 (80.0%) | 0.17 |
Toxicity Awareness | 264 (84.1%) | 53 (20.1%) | 114 (43.2%) | 97 (36.7%) | 0.04 |
Dependency Awareness | 165 (59.1%) | 31 (18.8%) | 66 (40.0%) | 68 (41.2%) | 0.91 |
Psychiatric Pathology | 46 (14.6%) | 8 (17.4%) | 17 (37.0%) | 21 (45.7%) | 0.68 |
HADS Depression (Positive) | 21 (10.8%) | 2 (9.5%) | 7 (33.3%) | 12 (57.1%) | 0.16 |
HADS Anxiety (Positive) | 36 (18.5%) | 4 (11.1%) | 19 (52.8%) | 13 (36.1%) | 0.68 |
Maladaptive Personality Traits | 25 (8.1%) | 5 (20.0%) | 8 (32.0%) | 12 (48.0%) | 0.56 |
Group 1: Non-Smokers (n = 59) | Group 2: Ex-Smokers (n = 130) | Group 3: Active Smokers (n = 125) | p | |
---|---|---|---|---|
Alcohol Use Relapse | 10 | 25 | 35 | 0.13 |
Substance Use Relapse | 1 | 0 | 8 | 0.02 |
Graft Cirrhosis | 10 | 17 | 18 | 0.77 |
Biopsy-Proven Alcoholic Steatohepatitis | 2 | 2 | 1 | 0.52 |
HCC Recurrence | 3 | 3 | 6 | 0.33 |
Skin Cancer | 2 | 4 | 3 | 0.92 |
Non–Skin Cancer | 2 | 14 | 18 | 0.04 |
OR (95% CI) | p | |
---|---|---|
Higher Risk of Being an Active Smoker Until LT | ||
Age | 0.94 (0.89–0.99) | 0.01 |
MELD | 1.06 (1.01–1.12) | 0.03 |
Comorbid Substance Use Disorder | 2.35 (1.11–4.96) | 0.03 |
Higher Risk of Being an Active Smoker After LT | ||
Abstinence Period Of 6 Months or Less | 3.23 (1.19–8.78) | 0.02 |
Comorbid Substance Use Disorder | 4.87 (2.17–10.96) | 0.00 |
Alcohol Dependency Awareness | 0.43 (0.19–0.97) | 0.04 |
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López-Lazcano, A.I.; Gual, A.; Colmenero, J.; Caballería, E.; Lligoña, A.; Navasa, M.; Crespo, G.; López, E.; López-Pelayo, H. Active Smoking Before Liver Transplantation in Patients with Alcohol Use Disorder: Risk Factors and Outcomes. J. Clin. Med. 2020, 9, 2710. https://doi.org/10.3390/jcm9092710
López-Lazcano AI, Gual A, Colmenero J, Caballería E, Lligoña A, Navasa M, Crespo G, López E, López-Pelayo H. Active Smoking Before Liver Transplantation in Patients with Alcohol Use Disorder: Risk Factors and Outcomes. Journal of Clinical Medicine. 2020; 9(9):2710. https://doi.org/10.3390/jcm9092710
Chicago/Turabian StyleLópez-Lazcano, Ana Isabel, Antoni Gual, Jordi Colmenero, Elsa Caballería, Anna Lligoña, Miquel Navasa, Gonzalo Crespo, Eva López, and Hugo López-Pelayo. 2020. "Active Smoking Before Liver Transplantation in Patients with Alcohol Use Disorder: Risk Factors and Outcomes" Journal of Clinical Medicine 9, no. 9: 2710. https://doi.org/10.3390/jcm9092710