Correlates and outcomes of alcohol use after single solid organ transplantation

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

VL - 33

SP - 17

EP - 28

JO - Transplantation Reviews

JF - Transplantation Reviews

SN - 0955-470X

IS - 1

ER -