A study led by McGowan Institute for Regenerative Medicine faculty member Mary Amanda Dew, PhD, Professor of Psychiatry at the University of Pittsburgh and the Director of the Clinical Epidemiology Program at the Western Psychiatric Institute and Clinic of UPMC, found that only about 6 percent of former alcoholics and 4 percent of former illicit drug users will relapse into their addictions in any given year following an organ transplant.
“Substance abuse can lead to serious organ diseases for which transplantation is increasingly considered an acceptable treatment,” noted Dr. Dew. “Still, the transplant community remains concerned about these patients resuming their harmful behaviors once the transplant has been done.”
Studies have suggested vast disparities in the prevalence of addiction relapse after transplantation. By conducting a meta-analysis of studies published between 1983 and 2005, the researchers sought to establish precise estimates of the rates of alcohol and drug relapse in individuals receiving liver or other solid organ transplants. They also looked for associations between relapse and many pre-transplant or psychosocial characteristics.
The researchers included 54 studies (all but four pertaining to liver recipients) that described more than 3,600 former substance abusers who had received transplants. They examined the following post-transplant outcomes: alcohol relapse, heavy alcohol use, illicit drug relapse, tobacco use, non-adherence to immunosuppressants, and non-adherence to clinic appointments.
The average rate for alcohol relapse was approximately 6 cases per 100 persons per year of observation (PPY). The average rate for relapse to heavy alcohol use was 2.5 per 100 PPY. The average relapse to illicit drug use was 3.7 per 100 PPY. Relapse rates for the other studied outcomes ranged from 2 to 10 cases per 100 PPY.
Due to the amount of data available, relapse risk factors could be assessed only for alcohol use. While demographics and pre-transplant characteristics showed little correlation with relapse, poor social support, family alcohol history, and pre-transplant abstinence of less than 6 months showed small but significant associations with relapse.
“Future research should focus on improving the prediction of risk for substance abuse relapse, and on testing interventions to promote continued abstinence post-transplant. Interventions are important because, although the risk of relapse is small during any given year, as the years add up the likelihood of relapse increases,” Dr. Dew concluded.
Illustration: McGowan Institute for Regenerative Medicine.
Science Daily (02/05/08)
UPMC/University of Pittsburgh Schools of the Health Sciences Media Relations (02/11/08)
Pittsburgh Post-Gazette (02/11/08)
Pittsburgh Tribune-Review (02/11/08)
Health News Digest (02/12/08)