{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T13:18:18Z","timestamp":1762867098340,"version":"3.37.3"},"reference-count":24,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2017,6,4]],"date-time":"2017-06-04T00:00:00Z","timestamp":1496534400000},"content-version":"vor","delay-in-days":3,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Internal Medicine Journal"],"published-print":{"date-parts":[[2017,6]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Limited studies of patient survival and alcoholic relapse following transplantation for alcoholic liver disease have been described in Australian populations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To describe these outcomes in an Australian population, to determine the association between harmful alcoholic relapse and patient survival, and to examine pre\u2010transplant variables associated with harmful relapse.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Single centre, retrospective review of consecutive patients transplanted at the South Australian Liver Transplant Unit. Relapse was identified by an independent investigator using case note review and confidential patient questionnaire.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 87 patients (median age 52 years, 84% male, median Model for End\u2010Stage Liver Disease (<jats:styled-content style=\"fixed-case\">MELD<\/jats:styled-content>) score 18) was included in the study with a median follow\u2010up time of 50\u2009months. The 1\u2010, 3\u2010 and 5\u2010year survival of patients was 93.1, 87.4 and 82.0% respectively. Two deaths were directly attributable to graft failure due to alcohol. Fourteen (16%) patients fulfilled criteria for harmful relapse and 18 (21%) patients experienced any form of relapse to alcohol. Harmful relapse was associated with increased mortality (hazard ratio (<jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content>) 3.2, 95% confidence interval (<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>) 1.1\u20139.7, <jats:italic>P<\/jats:italic>\u2009=\u20090.041). Only two factors were independently associated with harmful relapse on multivariate analysis; prior alcohol rehabilitation (<jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content> 8.4, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 2.5\u201328.4, <jats:italic>P<\/jats:italic>\u2009=\u20090.001) and single versus married status (<jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content> 0.09, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 0.02\u20131.2, <jats:italic>P<\/jats:italic>\u2009=\u20090.019).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Good patient survival outcomes were seen for this South Australian population. Harmful alcohol relapse occurs in a minority of patients and rarely results in direct graft loss. Modifiable pre\u2010transplant factors that predict harmful relapse were not identified.<\/jats:p><\/jats:sec>","DOI":"10.1111\/imj.13431","type":"journal-article","created":{"date-parts":[[2017,3,21]],"date-time":"2017-03-21T08:09:38Z","timestamp":1490083778000},"page":"656-663","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Outcomes and predictors of harmful relapse following liver transplantation for alcoholic liver disease in an Australian population"],"prefix":"10.1111","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8054-5745","authenticated-orcid":false,"given":"Alan J.","family":"Wigg","sequence":"first","affiliation":[{"name":"South Australian Liver Transplant Unit Flinders Medical Centre  Adelaide South Australia Australia"},{"name":"Hepatology and Liver Transplantation Unit Flinders Medical Centre  Adelaide South Australia Australia"},{"name":"School of Medicine Flinders University  Adelaide South Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dileep","family":"Mangira","sequence":"additional","affiliation":[{"name":"South Australian Liver Transplant Unit Flinders Medical Centre  Adelaide South Australia Australia"},{"name":"Hepatology and Liver Transplantation Unit Flinders Medical Centre  Adelaide South Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John W.","family":"Chen","sequence":"additional","affiliation":[{"name":"South Australian Liver Transplant Unit Flinders Medical Centre  Adelaide South Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard W.","family":"Woodman","sequence":"additional","affiliation":[{"name":"School of Medicine Flinders University  Adelaide South Australia Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2017,6,4]]},"reference":[{"key":"e_1_2_6_2_1","unstructured":"World Health Organization. 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