P3718 - Factors Related to Alcohol Recidivism Following Liver Transplantation: A Retrospective Study

Aliza Rizwan, MD¹, Arif Sarowar, MD², Syed-Mohammed Jafri, MD³
1Henry Ford Health, Northville, MI; 2Wayne State University, Detroit, MI; 3Henry Ford Health, Detroit, MI

Introduction: Alcohol recidivism remains a major concern following liver transplantation for alcoholic liver disease (ALD). Identifying predictive factors, including psychiatric history, is critical to guide patient selection and post-transplant care. This study evaluates the relationship between pre-transplant psychiatric illness and post-transplant alcohol use.

Methods: We conducted a retrospective review of patients who underwent liver transplantation for ALD between 2020 and 2022 at a single center. Alcohol use post-transplant was assessed using phosphatidylethanol (PEth), with PEth >10 ng/mL considered positive and >100 ng/mL indicating high-risk recidivism. Data collected included psychiatric diagnoses, psychiatric follow-up within 1 and 3 months post-transplant, and demographic variables. Chi-square tests assessed associations between psychiatric variables and recidivism.

Results: Of 124 liver transplant recipients, 100 met inclusion criteria (mean age 54.5 ± 9.9 years; 68% male; 92% Caucasian). Within 1 year post-transplant, 16% had a positive PEth, and 6% had PEth >100 ng/mL. No significant association was found between recidivism and age, sex, race, or pre-existing psychiatric diagnosis (26% of cohort; p=0.65). Patients with positive PEth within 6 months were significantly more likely to reach PEth >100 ng/mL by 1 year (p=0.017). Notably, 63% of recidivists had psychiatric evaluation within 3 months post-transplant (p< 0.001).

Discussion: Pre-transplant psychiatric illness was not predictive of post-transplant alcohol recidivism in ALD patients. However, early post-transplant psychiatric follow-up was associated with higher detection of alcohol use, underscoring the importance of ongoing monitoring and support in this high-risk population.

Disclosures:
Aliza Rizwan indicated no relevant financial relationships.
Arif Sarowar indicated no relevant financial relationships.
Syed-Mohammed Jafri: Abbvie – Speakers Bureau. Gilead – Speakers Bureau. Intercept – Speakers Bureau. Ironwood – Speakers Bureau. Takeda – Speakers Bureau.

Aliza Rizwan, MD¹, Arif Sarowar, MD², Syed-Mohammed Jafri, MD³. P3718 - Factors Related to Alcohol Recidivism Following Liver Transplantation: A Retrospective Study, ACG 2025 Annual Scientific Meeting Abstracts. Phoenix, AZ: American College of Gastroenterology.