Alcoholism treatment after liver transplantation: Lessons learned from a clinical trial that failed

Alcoholic liver disease is the second most common indication far liver tran splantation in the United States. The lack of alcoholism treatment studies led us to study motivational enhancement therapy (MET) plus naltrexone afte r transplant. The authors could not complete this study. Sixty alcoholic pa tients were to receive MET plus naltrexone or placebo for 6 months. Fifty m en and 5 women were screened. Nine died and 15 were not approached Of 31 ap proached 20 were ineligible, II refused and 5 entered but dropped out befor e completion. Barriers to posttransplant alcoholism included infirmity, int ensive medical management, and denial for alcoholism treatment. Because 30% -50% of alcoholic patients drink after transplant, the authors suggest usin g MET alone pretransplant.