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16 November 2017 : Case report  Japan

Successful Post-Transplant Psychiatric Interventions During Long-Term Follow-Up of Patients Receiving Liver Transplants for Alcoholic Liver Disease

Unusual setting of medical care

Hiroyuki Kimura1ABCDEF*, Yasuharu Onishi2ABCDFG, Shinichi Kishi1ABCDF, Nobuhiko Kurata2BDF, Satoshi Ogiso2BDF, Hideya Kamei2BDF, Chisato Tsuboi3BD, Naoko Yamaguchi3BD, Azusa Shiga1BDF, Mai Kondo1BDF, Yushun Yokoyama1BD, Fumika Takasato1BD, Hiroshige Fujishiro1BDF, Kanako Ishizuka1BDF, Takashi Okada1BDF, Yasuhiro Ogura2BCDF, Norio Ozaki1ADF

DOI: 10.12659/AJCR.906446

Am J Case Rep 2017; 18:1215-1219

Abstract

BACKGROUND: Around 20–30% of patients who undergo liver transplantation (LT) for alcoholic liver disease (ALD) will resume heavy drinking after LT. It is crucial to control post-transplant relapse of alcohol use, because alcoholic recidivism has been shown to have a negative impact on post-transplant compliance and long-term outcomes of LT recipients. However, there is currently no specific, effective psychiatric intervention for preventing additional alcohol consumption in clinical practice.

CASE REPORT: We present 3 patients who underwent LT for ALD at Nagoya University Hospital who were followed up for prolonged periods (7.2, 8.8, and 11.3 years, respectively), and review the psychiatric interventions employed to address critical situations. Additional alcohol consumption was noted in Case 1, but prompt collaborative care led to stable abstinence. In Case 2, marked anger and irritation were exacerbated as a result of work, but the anger was controlled by anger management. Case 3 abused a minor tranquilizer, but limit-setting resulted in adequate medical adherence.

CONCLUSIONS: Transplant teams need to provide comprehensive treatment for alcoholic recidivism to improve long-term health after LT for ALD.

Keywords: Alcohol Abstinence, Liver Transplantation, Patient Care Team, Preventive Psychiatry

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American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923