SOCIAL REINTEGRATION AFTER LIVER TRANSPLANTATION FOR ALCOHOL-RELATED LIVER DISEASE.

Abstract

959 Enabling patients to return to society is a key goal of liver transplantation (OLTX). PATIENTS: We studied two groups of OLTX recipients: those transplanted for alcohol-related liver disease (ALD) and those transplanted for nonalcohol-related liver disease (Controls) to examine levels of employment, volunteerism, academe, support of others, and social involvement within the post-OLTX period. Over a 9-year period, 84 of 115 ALD OLTX recipients transplanted at our institution were available for study. Another 68 nonalcoholic OLTX recipients age/sex and temporally-matched served as a control group. RESULTS: Overall mean age at the time of the survey was 54 years (30 to 73) at a mean follow-up of 52 months (24 to 18). Nearly 80% of the patients in both groups were men (Control 81% men, ALD 79% men). (Table)TableIn both groups, approximately 70% of those working reported working at least 40 hours/week. Men were nearly twice as likely as women to be employed when surveyed (Controls 38% men vs. 17% of women, ALDs 42% men vs. 23% women). Of those not working, 71% of Controls and 54% of ALDs reported health-related reasons for their nonemployment (retired due to poor health either before or after OLTX, or presently disabled). Of the Control's 42 nonemployed recipients, 52% (n=22) reported themselves as either students or homemakers compared with 41% (n=23) of ALD's nonemployed recipients. Greater income was significantly linked to employment (P=0.0001). Fifty-three percent of Controls (n=36) and 43% of ALDs (n=36) reported providing support for others through care-giving and/or financial means. As many as 94% of Controls and 81% of ALDs reported involvement in vocational, domestic, academic, and/or social activities post-OLTX. CONCLUSIONS: Patients transplanted for alcohol- and nonalcohol-related liver disease alike appear to successfully reintegrate into society, resuming socially active and productive lives. ALD patients are probably less "socially involved" than control populations. A pretransplant diagnosis of alcohol-related liver disease does not appear to preclude societal reintegration post-OLTX.