{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T05:01:49Z","timestamp":1776229309785,"version":"3.50.1"},"reference-count":12,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2025,9,5]],"date-time":"2025-09-05T00:00:00Z","timestamp":1757030400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,4,10]]},"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n Alcohol biomarkers including ethyl glucuronide (EtG) and phosphatidylethanol (PEth) are ordered frequently in clinical and forensic settings including solid organ transplantation. PEth provides a long detection window but can be insensitive to light drinking. In contrast, EtG and ethyl sulfate (EtS) can be elevated after light alcohol consumption and might complement PEth testing.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n Urine EtG\/EtS and whole blood PEth results were evaluated from all clinically-ordered testing between 2014 and 2024. PEth and EtG\/EtS confirmation were performed by liquid chromatography tandem mass spectrometry at two reference laboratories, using cutoffs: Lab A, PEth 20\u2009ng\/ml, EtG and EtS 500 and 250\u2009ng\/ml; Lab B, PEth 10\u2009ng\/ml, EtG and EtS 250 and 100\u2009ng\/ml. Only Lab B performed EtG screening by immunoassay, using a 500\u2009ng\/ml cutoff.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Phosphatidylethanol was positive in 1269 (15.6%) of 8131 samples, compared to 769 (6.7%) confirmed EtG\/EtS positives from 11\u2009555 samples. EtG screening (n\u2009=\u20099668) was positive in 743 (7.7%) samples, of which 30 (4.0%) confirmed negative (false positives); the screen was indeterminate in 267 (2.8%) samples, 66 of which confirmed positive and 172 negative. Of 3132 paired PEth and EtG samples, 2887 (92.2%) were concordant, 224 (7.2%) were PEth-positive, and 21 (0.7%) were EtG-positive. PEth was significantly more sensitive in paired samples (P\u2009&lt;\u2009.001), even after accounting for potential confounders such as transfusion. Limiting testing to PEth would have correctly identified alcohol consumption in 331 of 373 (88.7%) instances versus EtG\/EtS in 149 (39.9%), and reduced charges by &gt;$720\u2009000 USD.<\/jats:p>\n <\/jats:sec>\n \n Discussion<\/jats:title>\n Phosphatidylethanol outperformed EtG\/EtS in detecting alcohol consumption in a predominantly abstinent transplant population. Compared to PEth, EtG\/EtS had lower overall positivity and poorer sensitivity in paired samples; additionally, EtG screening demonstrated false positives and indeterminate results. EtG testing provided little added value beyond PEth in this population, and did not warrant the increased cost of performing both tests.<\/jats:p>\n <\/jats:sec>","DOI":"10.1093\/jat\/bkaf084","type":"journal-article","created":{"date-parts":[[2025,9,4]],"date-time":"2025-09-04T11:48:45Z","timestamp":1756986525000},"source":"Crossref","is-referenced-by-count":0,"title":["Limited added utility of urine ethyl glucuronide compared to blood phosphatidylethanol in a predominantly transplant population"],"prefix":"10.1093","volume":"50","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0769-7165","authenticated-orcid":false,"given":"Christine L H","family":"Snozek","sequence":"first","affiliation":[{"name":"Department of Laboratory Medicine, Mayo Clinic Arizona , Phoenix, AZ 85054,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul J","family":"Jannetto","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Mayo Clinic Rochester , Rochester, MN 55905,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Loralie J","family":"Langman","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Mayo Clinic Rochester , Rochester, MN 55905,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Theresa N","family":"Kinard","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Mayo Clinic Arizona , Phoenix, AZ 85054,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,9,5]]},"reference":[{"key":"2026041500165403900_bkaf084-B1","doi-asserted-by":"crossref","first-page":"1144","DOI":"10.1002\/hep.26972","article-title":"Evaluation for liver transplantation in adults: 2013 practice guideline by the American Association for the Study of Liver Diseases and the American Society of 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