A SURVEY ESTIMATE OF ACADEMIC LIVER-TRANSPLANT TEAMS SELECTION PRACTICES FOR ALCOHOL-DEPENDENT APPLICANTS

Alcoholism itself is not a contraindication to liver transplantation. However certain individual alcoholic applicants may pose an unacceptab ly high psychosocial risk of poor outcome. Transplant psychiatrists or psychologists at 14 academic liver transplant centers were asked to e stimate their centers' selection practices with regard to specific pro blems in the more difficult alcohol-dependent applicant and with regar d to hypothetical problem cases. Theta was impressive variability in e stimated selection practice between the centers. However the centers c onsistently appeared to prefer to require rehabilitation or observatio n in difficult situations rather than to reject applicants outright. T he results provide an initial estimate of current thinking and practic e with regard to the more difficult alcoholic applicant and suggest di rections for further study.