Liver Transplantation and the Alcoholic Patient: Medical, Surgical and Psychosocial Issues

Overview

Alcohol-induced liver disease, the most common cause of end-stage liver failure in the developed world, is treated increasingly by liver transplantation. This poses especially difficult dilemmas for health care workers in liver transplant programs. Combining the expertise of hepatologists, surgeons, and psychiatrists, this text reviews the medical, surgical, and psychosocial aspects of evaluation, surgery, and post-liver-transplant care in alcoholics. The authors offer important practical advice, and illustrate ...

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Overview

Alcohol-induced liver disease, the most common cause of end-stage liver failure in the developed world, is treated increasingly by liver transplantation. This poses especially difficult dilemmas for health care workers in liver transplant programs. Combining the expertise of hepatologists, surgeons, and psychiatrists, this text reviews the medical, surgical, and psychosocial aspects of evaluation, surgery, and post-liver-transplant care in alcoholics. The authors offer important practical advice, and illustrate possible solutions with examples from case histories. They conclude with a discussion of the ethical issues surrounding the controversial topic of liver transplantation in alcoholics. Essential reading for all involved in organ transplantation, this volume will provide valuable insight to all physicians, surgeons, psychiatrists, and health care professionals involved in the care of alcoholic patients.

This book contains black-and-white illustrations.

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Editorial Reviews

Doody's Review Service
Reviewer: Michael M. Abecassis, MD (Northwestern University Feinberg School of Medicine)
Description: This text provides a scientific and scholarly review of the medical, surgical, and psychosocial aspects of evaluation, surgery, and posttransplant care of patients undergoing liver transplantation for alcoholic cirrhosis.
Purpose: This monograph has two broad purposes. First, to offer a scholarly review of all aspects of liver transplantation in persons affected by alcoholism and second, to provide a practical guide for health care professionals involved in the selection of alcoholics for liver transplantation and their management after transplantation. These are worthy objectives, and there is a paucity of review literature on this subject. The book clearly meets the authors' objectives.
Audience: The book is intended for all those involved in organ transplantation, including physicians, surgeons, psychiatrists, and related health care professionals involved in the care of alcoholic patients. Presently, more than 20% of liver transplantations performed in the United States are done in patients with alcoholic cirrhosis. The decision to transplant these patients is a difficult one and it routinely involves a selections committee. The Michigan group has amassed a great deal of experience in this area, publishing several papers on the topic. As a result, the authors are very credible authorities.
Features: The illustrations are adequate. References are both current and pertinent. The table of contents and index are both adequate.
Assessment: This is a timely review of a relevant topic. Alcoholism is the most common etiology for cirrhosis in North America. The evaluation and pre- and postoperative management of these patients is challenging and requires a multidisciplinary approach. Despite the development of complex scales, the decision of whether an alcoholic should undergo liver transplant remains difficult. This book provides some very useful, practical guidelines and should be considered an important point of reference. It is a significant contribution by a group that has repeatedly made an effort to address this issue. It is of interest to a variety of health care providers and should be acquired by most libraries, bookstores, and certainly by all individuals involved in the treatment of these patients.
Michael M. Abecassis
This text provides a scientific and scholarly review of the medical, surgical, and psychosocial aspects of evaluation, surgery, and posttransplant care of patients undergoing liver transplantation for alcoholic cirrhosis. This monograph has two broad purposes. First, to offer a scholarly review of all aspects of liver transplantation in persons affected by alcoholism and second, to provide a practical guide for health care professionals involved in the selection of alcoholics for liver transplantation and their management after transplantation. These are worthy objectives, and there is a paucity of review literature on this subject. The book clearly meets the authors' objectives. The book is intended for all those involved in organ transplantation, including physicians, surgeons, psychiatrists, and related health care professionals involved in the care of alcoholic patients. Presently, more than 20% of liver transplantations performed in the United States are done in patients with alcoholic cirrhosis. The decision to transplant these patients is a difficult one and it routinely involves a selections committee. The Michigan group has amassed a great deal of experience in this area, publishing several papers on the topic. As a result, the authors are very credible authorities. The illustrations are adequate. References are both current and pertinent. The table of contents and index are both adequate. This is a timely review of a relevant topic. Alcoholism is the most common etiology for cirrhosis in North America. The evaluation and pre- and postoperative management of these patients is challenging and requires a multidisciplinary approach. Despite the development of complex scales, thedecision of whether an alcoholic should undergo liver transplant remains difficult. This book provides some very useful, practical guidelines and should be considered an important point of reference. It is a significant contribution by a group that has repeatedly made an effort to address this issue. It is of interest to a variety of health care providers and should be acquired by most libraries, bookstores, and certainly by all individuals involved in the treatment of these patients.

3 Stars from Doody
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Product Details

  • ISBN-13: 9780521433327
  • Publisher: Cambridge University Press
  • Publication date: 1/28/1994
  • Edition number: 1
  • Pages: 134
  • Product dimensions: 5.98 (w) x 8.98 (h) x 0.51 (d)

Table of Contents

List of contributors
Preface
1 An overview 1
2 Overt and covert alcoholism 6
3 Psychiatric assessment of alcoholic candidates for liver transplantation 29
4 Medical assessment of alcoholic candidates for liver transplantation 50
5 Outcome of liver transplantation for alcohol-related liver disease 80
6 Psychiatric follow-up care of alcohol-dependent liver graft recipients 96
7 Ethics, alcoholism and liver transplantation 113
Index 131
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