Active Smoking Before Liver Transplantation in Patients with Alcohol Use Disorder: Risk Factors and Outcomes
Tobacco use is more prevalent among alcohol liver disease (ALD) transplant patients and exerts harmful effects to the patient and to the graft. The aims of this study were to examine the impact of smoking status (nonsmoker, ex-smoker, active smoker) on patient survival and clinical outcomes, and to...
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| Format: | Article |
| Language: | English |
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MDPI AG
2020-08-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/9/9/2710 |
| _version_ | 1797556398233485312 |
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| author | Ana Isabel López-Lazcano Antoni Gual Jordi Colmenero Elsa Caballería Anna Lligoña Miquel Navasa Gonzalo Crespo Eva López Hugo López-Pelayo |
| author_facet | Ana Isabel López-Lazcano Antoni Gual Jordi Colmenero Elsa Caballería Anna Lligoña Miquel Navasa Gonzalo Crespo Eva López Hugo López-Pelayo |
| author_sort | Ana Isabel López-Lazcano |
| collection | DOAJ |
| description | Tobacco use is more prevalent among alcohol liver disease (ALD) transplant patients and exerts harmful effects to the patient and to the graft. The aims of this study were to examine the impact of smoking status (nonsmoker, ex-smoker, active smoker) on patient survival and clinical outcomes, and to assess risk factors for active smoking before and after liver transplant (LT). An observational retrospective cohort study with 314 ALD patients undergoing LT from January 2004 to April 2016. Recipients were followed until April 2017 or death. Kaplan–Meier and Cox proportional hazards regression analyses were used to assess risk of mortality according to smoking status before LT. Smokers had a 79% higher risk of dying than those who had never smoked or quit smoking before LT. Ex-smokers had a greater survival probability (96.2%, 93.8%, 86.9%, and 83.1% at 1, 3, 5, and 10 years after LT) than active smokers until LT (96.0%, 85.6%, 80.0%, and 70.4%). Active smokers before LT with poor toxicity awareness had more than a twofold higher risk of mortality (Cox HR = 2.20, 95% CI: 1.05–4.58, <i>p</i> = 0.04) than ex-smokers. Younger age (OR = 94), higher Model for End-Stage Liver Disease (MELD) (OR = 1.06), and comorbid substance use disorder (OR = 2.35) were predictors of smoking until LT. Six months or less of alcohol abstinence (OR = 3.23), and comorbid substance use disorder (OR = 4.87) were predictors of active smoking after LT. Quitting smoking before transplantation improved survival. Evidence based smoking cessation interventions should be offered before and after LT. |
| first_indexed | 2024-03-10T17:01:18Z |
| format | Article |
| id | doaj.art-cd8a3736427444b188121fe8563470a4 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T17:01:18Z |
| publishDate | 2020-08-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-cd8a3736427444b188121fe8563470a42023-11-20T10:58:07ZengMDPI AGJournal of Clinical Medicine2077-03832020-08-0199271010.3390/jcm9092710Active Smoking Before Liver Transplantation in Patients with Alcohol Use Disorder: Risk Factors and OutcomesAna Isabel López-Lazcano0Antoni Gual1Jordi Colmenero2Elsa Caballería3Anna Lligoña4Miquel Navasa5Gonzalo Crespo6Eva López7Hugo López-Pelayo8Grup Recerca Addicions Clínic (GRAC-GRE), Department of Psychiatry, Clinical Institute of Neuroscience, Hospital Clínic i Universitari de Barcelona, Universitat de Barcelona, IDIBAPS. RTA (RETICS). Villarroel, 170, 08036 Barcelona, SpainGrup Recerca Addicions Clínic (GRAC-GRE), Department of Psychiatry, Clinical Institute of Neuroscience, Hospital Clínic i Universitari de Barcelona, Universitat de Barcelona, IDIBAPS. RTA (RETICS). Villarroel, 170, 08036 Barcelona, SpainLiver Unit, Hospital Clínic i Universitari de Barcelona, Universitat de Barcelona, IDIBAPS. CIBERehd. Villaroel 170, 08036 Barcelona, SpainGrup Recerca Addicions Clínic (GRAC-GRE), Department of Psychiatry, Clinical Institute of Neuroscience, Hospital Clínic i Universitari de Barcelona, Universitat de Barcelona, IDIBAPS. RTA (RETICS). Villarroel, 170, 08036 Barcelona, SpainGrup Recerca Addicions Clínic (GRAC-GRE), Department of Psychiatry, Clinical Institute of Neuroscience, Hospital Clínic i Universitari de Barcelona, Universitat de Barcelona, IDIBAPS. RTA (RETICS). Villarroel, 170, 08036 Barcelona, SpainLiver Unit, Hospital Clínic i Universitari de Barcelona, Universitat de Barcelona, IDIBAPS. CIBERehd. Villaroel 170, 08036 Barcelona, SpainLiver Unit, Hospital Clínic i Universitari de Barcelona, Universitat de Barcelona, IDIBAPS. CIBERehd. Villaroel 170, 08036 Barcelona, SpainLiver Unit, Hospital Clínic i Universitari de Barcelona, Universitat de Barcelona, IDIBAPS. CIBERehd. Villaroel 170, 08036 Barcelona, SpainGrup Recerca Addicions Clínic (GRAC-GRE), Department of Psychiatry, Clinical Institute of Neuroscience, Hospital Clínic i Universitari de Barcelona, Universitat de Barcelona, IDIBAPS. RTA (RETICS). Villarroel, 170, 08036 Barcelona, SpainTobacco use is more prevalent among alcohol liver disease (ALD) transplant patients and exerts harmful effects to the patient and to the graft. The aims of this study were to examine the impact of smoking status (nonsmoker, ex-smoker, active smoker) on patient survival and clinical outcomes, and to assess risk factors for active smoking before and after liver transplant (LT). An observational retrospective cohort study with 314 ALD patients undergoing LT from January 2004 to April 2016. Recipients were followed until April 2017 or death. Kaplan–Meier and Cox proportional hazards regression analyses were used to assess risk of mortality according to smoking status before LT. Smokers had a 79% higher risk of dying than those who had never smoked or quit smoking before LT. Ex-smokers had a greater survival probability (96.2%, 93.8%, 86.9%, and 83.1% at 1, 3, 5, and 10 years after LT) than active smokers until LT (96.0%, 85.6%, 80.0%, and 70.4%). Active smokers before LT with poor toxicity awareness had more than a twofold higher risk of mortality (Cox HR = 2.20, 95% CI: 1.05–4.58, <i>p</i> = 0.04) than ex-smokers. Younger age (OR = 94), higher Model for End-Stage Liver Disease (MELD) (OR = 1.06), and comorbid substance use disorder (OR = 2.35) were predictors of smoking until LT. Six months or less of alcohol abstinence (OR = 3.23), and comorbid substance use disorder (OR = 4.87) were predictors of active smoking after LT. Quitting smoking before transplantation improved survival. Evidence based smoking cessation interventions should be offered before and after LT.https://www.mdpi.com/2077-0383/9/9/2710smokingalcohol use disorderliver transplantrisk factorssurvival |
| spellingShingle | Ana Isabel López-Lazcano Antoni Gual Jordi Colmenero Elsa Caballería Anna Lligoña Miquel Navasa Gonzalo Crespo Eva López Hugo López-Pelayo Active Smoking Before Liver Transplantation in Patients with Alcohol Use Disorder: Risk Factors and Outcomes Journal of Clinical Medicine smoking alcohol use disorder liver transplant risk factors survival |
| title | Active Smoking Before Liver Transplantation in Patients with Alcohol Use Disorder: Risk Factors and Outcomes |
| title_full | Active Smoking Before Liver Transplantation in Patients with Alcohol Use Disorder: Risk Factors and Outcomes |
| title_fullStr | Active Smoking Before Liver Transplantation in Patients with Alcohol Use Disorder: Risk Factors and Outcomes |
| title_full_unstemmed | Active Smoking Before Liver Transplantation in Patients with Alcohol Use Disorder: Risk Factors and Outcomes |
| title_short | Active Smoking Before Liver Transplantation in Patients with Alcohol Use Disorder: Risk Factors and Outcomes |
| title_sort | active smoking before liver transplantation in patients with alcohol use disorder risk factors and outcomes |
| topic | smoking alcohol use disorder liver transplant risk factors survival |
| url | https://www.mdpi.com/2077-0383/9/9/2710 |
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