Abstract
Background: Reviews on alcohol use in transplant recipients focus on liver recipients and their risk of post-transplant rejection, but do not assess alcohol use in kidney, heart, or lung transplant recipients. This systematic review and meta-analysis aims to synthesize the evidence on correlates and outcomes of any alcohol use and at-risk drinking after solid organ transplantation (Tx). Methods: We searched 4 databases for quantitative studies in adult heart, liver, kidney and lung Tx recipients, investigating associations between post-Tx alcohol use and correlates and/or clinical, economic or quality of life outcomes. Paper selection, data extraction and quality assessment were performed by 2 reviewers independently. A pooled odds ratio (OR) was computed for each correlate/outcome reported ≥5 times. Results: Of the 5331 studies identified, 76 were included in this systematic review (93.3% on liver Tx; mean sample size 148.9 (SD = 160.2); 71.9% male; mean age 48.9 years (SD = 6.5); mean time post-Tx 57.7 months (SD = 23.1)). On average, 23.6% of patients studied used alcohol post-transplant. Ninety-three correlates of any post-Tx alcohol use were identified, and 9 of the 19 pooled ORs were significantly associated with a higher odds for any post-Tx alcohol use: male gender, being employed post-transplant, smoking pre-transplant, smoking post-transplant, a history of illicit drug use, having first-degree relatives who have alcohol-related problems, sobriety <6 months prior to transplant, a history of psychiatric illness, and having received treatment for alcohol-related problems pre-transplant. On average 15.1% of patients had at-risk drinking. A pooled OR was calculated for 6 of the 47 correlates of post-Tx at risk drinking investigated, of which pre-transplant smoking was the only correlate being significantly associated with this behavior. None of the outcomes investigated were significantly associated with any use or at-risk drinking. Conclusion: Correlates of alcohol use remain under-investigated in solid organ transplant recipients other than liver transplantation. Further research is needed to determine whether any alcohol use or at-risk drinking is associated with poorer post-transplant outcomes. Our meta-analysis highlights avenues for future research of higher methodological quality and improved clinical care. Protocol registration: PROSPERO protocol CRD42015003333
| Original language | English (US) |
|---|---|
| Pages (from-to) | 17-28 |
| Number of pages | 12 |
| Journal | Transplantation Reviews |
| Volume | 33 |
| Issue number | 1 |
| DOIs | |
| State | Published - Jan 1 2019 |
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Keywords
- Alcohol use
- Meta-analysis
- Post-transplant outcome
- Risk factors
- Solid organ transplantation
- Systematic review
ASJC Scopus subject areas
- Transplantation
Cite this
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Correlates and outcomes of alcohol use after single solid organ transplantation : A systematic review and meta-analysis. / on behalf of the B-SERIOUS consortium.
In: Transplantation Reviews, Vol. 33, No. 1, 01.01.2019, p. 17-28.Research output: Contribution to journal › Review article
TY - JOUR
T1 - Correlates and outcomes of alcohol use after single solid organ transplantation
T2 - A systematic review and meta-analysis
AU - on behalf of the B-SERIOUS consortium
AU - Dobbels, Fabienne
AU - Denhaerynck, Kris
AU - Klem, Mary Lou
AU - Sereika, Susan M.
AU - De Geest, Sabina
AU - De Simone, Paolo
AU - Berben, Lut
AU - Binet, Isabelle
AU - Burkhalter, Hanna
AU - Drent, Gerda
AU - Duerinckx, Nathalie
AU - Engberg, Sandra J.
AU - Glass, Tracy
AU - Gordon, Elisa
AU - Kirsch, Monika
AU - Kugler, Christiane
AU - Lerret, Stacee
AU - Rossmeissl, Anja
AU - Russell, Cynthia
AU - Schmidt-Trucksäss, Arno
AU - de Almeida, Samira Scalso
PY - 2019/1/1
Y1 - 2019/1/1
N2 - Background: Reviews on alcohol use in transplant recipients focus on liver recipients and their risk of post-transplant rejection, but do not assess alcohol use in kidney, heart, or lung transplant recipients. This systematic review and meta-analysis aims to synthesize the evidence on correlates and outcomes of any alcohol use and at-risk drinking after solid organ transplantation (Tx). Methods: We searched 4 databases for quantitative studies in adult heart, liver, kidney and lung Tx recipients, investigating associations between post-Tx alcohol use and correlates and/or clinical, economic or quality of life outcomes. Paper selection, data extraction and quality assessment were performed by 2 reviewers independently. A pooled odds ratio (OR) was computed for each correlate/outcome reported ≥5 times. Results: Of the 5331 studies identified, 76 were included in this systematic review (93.3% on liver Tx; mean sample size 148.9 (SD = 160.2); 71.9% male; mean age 48.9 years (SD = 6.5); mean time post-Tx 57.7 months (SD = 23.1)). On average, 23.6% of patients studied used alcohol post-transplant. Ninety-three correlates of any post-Tx alcohol use were identified, and 9 of the 19 pooled ORs were significantly associated with a higher odds for any post-Tx alcohol use: male gender, being employed post-transplant, smoking pre-transplant, smoking post-transplant, a history of illicit drug use, having first-degree relatives who have alcohol-related problems, sobriety <6 months prior to transplant, a history of psychiatric illness, and having received treatment for alcohol-related problems pre-transplant. On average 15.1% of patients had at-risk drinking. A pooled OR was calculated for 6 of the 47 correlates of post-Tx at risk drinking investigated, of which pre-transplant smoking was the only correlate being significantly associated with this behavior. None of the outcomes investigated were significantly associated with any use or at-risk drinking. Conclusion: Correlates of alcohol use remain under-investigated in solid organ transplant recipients other than liver transplantation. Further research is needed to determine whether any alcohol use or at-risk drinking is associated with poorer post-transplant outcomes. Our meta-analysis highlights avenues for future research of higher methodological quality and improved clinical care. Protocol registration: PROSPERO protocol CRD42015003333
AB - Background: Reviews on alcohol use in transplant recipients focus on liver recipients and their risk of post-transplant rejection, but do not assess alcohol use in kidney, heart, or lung transplant recipients. This systematic review and meta-analysis aims to synthesize the evidence on correlates and outcomes of any alcohol use and at-risk drinking after solid organ transplantation (Tx). Methods: We searched 4 databases for quantitative studies in adult heart, liver, kidney and lung Tx recipients, investigating associations between post-Tx alcohol use and correlates and/or clinical, economic or quality of life outcomes. Paper selection, data extraction and quality assessment were performed by 2 reviewers independently. A pooled odds ratio (OR) was computed for each correlate/outcome reported ≥5 times. Results: Of the 5331 studies identified, 76 were included in this systematic review (93.3% on liver Tx; mean sample size 148.9 (SD = 160.2); 71.9% male; mean age 48.9 years (SD = 6.5); mean time post-Tx 57.7 months (SD = 23.1)). On average, 23.6% of patients studied used alcohol post-transplant. Ninety-three correlates of any post-Tx alcohol use were identified, and 9 of the 19 pooled ORs were significantly associated with a higher odds for any post-Tx alcohol use: male gender, being employed post-transplant, smoking pre-transplant, smoking post-transplant, a history of illicit drug use, having first-degree relatives who have alcohol-related problems, sobriety <6 months prior to transplant, a history of psychiatric illness, and having received treatment for alcohol-related problems pre-transplant. On average 15.1% of patients had at-risk drinking. A pooled OR was calculated for 6 of the 47 correlates of post-Tx at risk drinking investigated, of which pre-transplant smoking was the only correlate being significantly associated with this behavior. None of the outcomes investigated were significantly associated with any use or at-risk drinking. Conclusion: Correlates of alcohol use remain under-investigated in solid organ transplant recipients other than liver transplantation. Further research is needed to determine whether any alcohol use or at-risk drinking is associated with poorer post-transplant outcomes. Our meta-analysis highlights avenues for future research of higher methodological quality and improved clinical care. Protocol registration: PROSPERO protocol CRD42015003333
KW - Alcohol use
KW - Meta-analysis
KW - Post-transplant outcome
KW - Risk factors
KW - Solid organ transplantation
KW - Systematic review
UR - http://www.scopus.com/inward/record.url?scp=85057020986&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85057020986&partnerID=8YFLogxK
U2 - 10.1016/j.trre.2018.09.003
DO - 10.1016/j.trre.2018.09.003
M3 - Review article
C2 - 30472153
AN - SCOPUS:85057020986
VL - 33
SP - 17
EP - 28
JO - Transplantation Reviews
JF - Transplantation Reviews
SN - 0955-470X
IS - 1
ER -