Bednar, Samantha
(2024)
A Program to Reduce Post-Transplant Alcohol Use.
Master's Thesis, University of Pittsburgh.
(Unpublished)
Abstract
Due to the scarcity of available organs for patients on the liver transplant waiting list, not everyone who needs a liver transplant will receive one. Thus, it is vital that transplant centers provide patients with resources and support to take proper care of their new organ, including abstaining from drinking alcohol. Alcohol-related Liver Disease is now the most common indication for liver transplant. Patients who excessively consume alcohol after transplant are at higher risk of negative outcomes, like graft failure/loss or death. A number of pre-transplant factors predict post-transplant alcohol use, including age, level of social support, length of sobriety, smoking, and
comorbid psychiatric disorders. These factors can be used in risk stratification models to predict the likelihood that a patient will struggle with recurrence of alcohol use after transplant. This study seeks to understand whether providers at the Starzl Transplantation Institute (STI) believe that
post-transplant alcohol use is an issue and whether UPMC has the resources to assess and treat patients who experience a recurrence of alcohol use after transplant. Members of the liver transplant selection committee were invited to complete a survey to assess these factors. Results
demonstrate that providers do believe post-transplant alcohol use is an issue among patients at UPMC and that the STI can do more to assess and treat patients who resume drinking after transplant. Additionally, the study seeks to identify the extent of this issue at UPMC through a chart review of 75 patients who received a liver transplant at UPMC during a 4-year period. Results of the chart review demonstrate that 28% of patients examined had at least one instance of documented alcohol use after receiving their transplant. Finally, numerous recommendations are provided to improve documentation and tracking of post-transplant alcohol use and provide more comprehensive treatment to patients who experience a recurrence of alcohol use after transplant. These recommendations include consistent Phosphatidylethanol testing, improved provider documentation, changes to protocols at the STI, increasing and improving in-house resources, and educating providers.
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Details
| Item Type: |
University of Pittsburgh ETD
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| Status: |
Unpublished |
| Creators/Authors: |
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| ETD Committee: |
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| Date: |
17 May 2024 |
| Date Type: |
Publication |
| Defense Date: |
1 April 2024 |
| Approval Date: |
17 May 2024 |
| Submission Date: |
4 April 2024 |
| Access Restriction: |
2 year -- Restrict access to University of Pittsburgh for a period of 2 years. |
| Number of Pages: |
67 |
| Institution: |
University of Pittsburgh |
| Schools and Programs: |
School of Public Health > Behavioral and Community Health Sciences |
| Degree: |
MPH - Master of Public Health |
| Thesis Type: |
Master's Thesis |
| Refereed: |
Yes |
| Uncontrolled Keywords: |
transplant, liver, liver transplant, alcohol, alcohol use disorder, alcohol-related liver disease, alcoholic cirrhosis, alcoholic liver disease, liver disease |
| Date Deposited: |
17 May 2024 17:13 |
| Last Modified: |
17 May 2024 17:13 |
| URI: |
http://d-scholarship.pitt.edu/id/eprint/46028 |
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