{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T16:51:21Z","timestamp":1788886281197,"version":"build-2803163510"},"reference-count":25,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","license":[{"start":{"date-parts":[[2019,1,17]],"date-time":"2019-01-17T00:00:00Z","timestamp":1547683200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"},{"start":{"date-parts":[[2019,1,17]],"date-time":"2019-01-17T00:00:00Z","timestamp":1547683200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Hepatology"],"published-print":{"date-parts":[[2019,7]]},"abstract":"<jats:p>Between 14%\u201030% of the world\u2019s population is affected by alcohol use disorder (AUD), and excessive alcohol consumption represents the most common cause of liver disease in the western world. The clinical picture of alcoholic end\u2010stage liver disease is rendered extremely complex, as manifestations such as alcohol withdrawal syndrome, craving and physical dependence, as well as extrahepatic alcohol\u2010related diseases merge with the complications of advanced cirrhosis. This makes AUD recognition and assessment difficult and its management arduous as many drugs commonly used to treat complications such as alcohol withdrawal syndrome are often contraindicated by the presence of hepatic encephalopathy or hepatorenal syndrome. Reaching and maintaining abstinence represents the mainstay of managing patients with AUD and end\u2010stage liver disease. Psychosocial interventions are an essential component of treatment to reach these goals. However, these interventions alone often prove insufficient in AUD patients and even more frequently in those with end\u2010stage liver disease because of inadequate adherence due to poor functional and physical status. Pharmacological treatments need to be associated, but the available options are greatly limited in end\u2010stage liver disease because many GABA\u2010Ergic drugs can favor the development of hepatic encephalopathy, whereas drugs undergoing extensive liver metabolism should be avoided or used with the greatest caution. Because of these limitations, the management of end\u2010stage AUD is extremely challenging and requires an integrated multidisciplinary approach.<\/jats:p>","DOI":"10.1002\/hep.30358","type":"journal-article","created":{"date-parts":[[2018,11,24]],"date-time":"2018-11-24T16:09:26Z","timestamp":1543075766000},"page":"410-417","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":51,"title":["Diagnosis and Treatment of Alcohol Use Disorder in Patients With End\u2010Stage Alcoholic Liver Disease"],"prefix":"10.1097","volume":"70","author":[{"given":"Fabio","family":"Caputo","sequence":"first","affiliation":[{"name":"Department of Internal Medicine,SS Annunziata Hospital,Cento (Ferrara),Italy"},{"name":"\u201cG. 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