Carbohydrate deficient transferrin for detection of alcohol relapse after orthotopic liver transplantation for alcoholic cirrhosis

Early diagnosis and monitoring of an alcohol relapse in patients after orth otopic liver transplantation for alcoholic cirrhosis is of importance for t he long-term outcome. A prospective study of 97 patients who underwent orthotopic liver transplan t for alcoholic cirrhosis has been performed. All of the recipients conside red for analysis survived for at least 3 months and were under the care of one specialist psychologist. Mean follow-up amounted to 48.5 +/- 1.4 months . The rates of alcohol relapse at 1 and 3 years after orthotopic liver tran splant were 6 and 9%, respectively. Carbohydrate-deficient transferrin is a biological marker for alcohol abuse independently of liver disease and has been used for the first time ever i n liver graft recipients. A total of 830 values were included prospectively in the study population. Detection of alcohol relapse had a sensitivity of 92% and a specificity of 98%. Changes in carbohydrate-deficient transferri n levels indicated clandestine and sporadic drinking after transplantation. Furthermore, clinical events were not found to influence carbohydrate-defi cient transferrin, either in patients with or without alcoholic relapse. In our opinion, carbohydrate-deficient transferrin is a useful screening ma rker for alcohol relapse in patients after orthotopic liver transplant for alcoholic cirrhosis, to select those patients who need special attention fr om the psychologist.