Psychosoziale Evaluation von Patienten mit einer alkohol-assoziierten Lebererkrankung

Eine Lebertransplantation ist im Endstadium alkoholassoziierter Lebererkrankungen die einzige lebensrettende Behandlungsmaßnahme. Vor Aufnahme in die Transplantationswarteliste ist für Patienten mit dieser Diagnose eine psychosoziale Evaluation vorgeschrieben. Der Beitrag beinhaltet Hinweise zum Vorgehen und die relevanten Beurteilungskriterien für eine psychosoziale Evaluation.

Publication History

Article published online:
14 March 2025

• Literatur

• 1 Adam R, Karam V, Cailliez V. et al. 2018 Annual Report of the European Liver Transplant Registry (ELTR) – 50-year evolution of liver transplantation. Transplant International 2018; 31: 1293-1317
• 2 Müller PC, Kabacam G, Vibert E. et al. Current status of liver transplantation in Europe. Int J Surg 2020; 82s: 22-29
• 3 Anantharaju A, Van Thiel DH. Liver transplantation for alcoholic liver disease. Alcohol Res Health 2003; 27: 257-268
• 4 Transplantationsgesetz. Neubekanntmachung der Richtlinie gem. § 16 Abs. 1 S. 1 Nrn. 2 und 5 TPG für die Wartelistenführung und Organvermittlung zur Lebertransplantation. Allgemeiner Teil – Besonderer Teil. Deutsches Ärzteblatt 2023;
• 5 Deutsche Gesellschaft für Psychosomatische Medizin und Ärztliche Psychotherapie e.V. (DGPM) DKfpMeVD. Psychosoziale Diagnostik und Behandlung von Patientinnen und Patienten vor und nach Organtransplantation. 2022.
• 6 Kröncke S, Greif-Higer G, Albert W. et al. Psychosoziale Evaluation von Transplantationspatienten – Empfehlungen für die Richtlinien zur Organtransplantation. Psychother Psychosom Med Psychol 2018; 68: 179-184
• 7 Louvet A, Labreuche J, Moreno C. et al. Early liver transplantation for severe alcohol-related hepatitis not responding to medical treatment: a prospective controlled study. Lancet Gastroenterol Hepatol 2022; 7: 416-425
• 8 Mathurin P, Moreno C, Samuel D. et al. Early Liver Transplantation for Severe Alcoholic Hepatitis. New England Journal of Medicine 2011; 365: 1790-1800
• 9 Lee BP, Mehta N, Platt L. et al. Outcomes of Early Liver Transplantation for Patients With Severe Alcoholic Hepatitis. Gastroenterology 2018; 155: 422-430.e421
• 10 Im GY, Cameron AM, Lucey MR. Liver transplantation for alcoholic hepatitis. Journal of hepatology 2019; 70: 328-334
• 11 Hammond C, Hussaini T, Yoshida EM. Medical adherence and liver transplantation: a brief review. Canadian Liver Journal 2021; 4: 8-15
• 12 Young K, Patel YA, Hoffman B. et al. Alcohol Relapse after Liver Transplantation: Risk Factors, Outcomes, and a Comparison of Risk Stratification Models. Gastro Hep Advances 2024;
• 13 Onishi Y, Kimura H, Hori T. et al. Risk of alcohol use relapse after liver transplantation for alcoholic liver disease. World journal of gastroenterology 2017; 23: 869-875
• 14 Choudhary NS, Kumar N, Saigal S. et al. Liver Transplantation for Alcohol-Related Liver Disease. J Clin Exp Hepatol 2016; 6: 47-53
• 15 Maldonado JR, Dubois HC, David EE. et al. The Stanford Integrated Psychosocial Assessment for Transplantation (SIPAT): a new tool for the psychosocial evaluation of pre-transplant candidates. Psychosomatics 2012; 53: 123-132
• 16 Lim J, Sundaram V. Risk factors, scoring systems, and interventions for alcohol relapse after liver transplantation for alcoholic liver disease. Clin Liver Dis (Hoboken) 2018; 11: 105-110
• 17 Deutsch-Link S, Weinberg EM, Bittermann T. et al. The Stanford Integrated Psychosocial Assessment for Transplant Is Associated With Outcomes Before and After Liver Transplantation. Liver Transplantation 2021; 27: 652-667
• 18 Deutsch-Link S, Weinrieb RM, Jones LS. et al. Prior Relapse, Ongoing Alcohol Consumption, and Failure to Engage in Treatment Predict Alcohol Relapse After Liver Transplantation. Dig Dis Sci 2020; 65: 2089-2103
• 19 Twillman RK, Manetto C, Wellisch DK. et al. The Transplant Evaluation Rating Scale. A revision of the psychosocial levels system for evaluating organ transplant candidates. Psychosomatics 1993; 34: 144-153
• 20 Erim Y, Scheel J, Beckmann M. et al. Standardized Evaluation of Candidates Before Liver Transplantation With the Transplant Evaluation Rating Scale. Psychosomatics 2017; 58: 141-150
• 21 De Gottardi A, Spahr L, Gelez P. et al. A Simple Score for Predicting Alcohol Relapse After Liver Transplantation: Results From 387 Patients Over 15 Years. Archives of Internal Medicine 2007; 167: 1183-1188
• 22 Lee BP, Chen PH, Haugen C. et al. Three-year Results of a Pilot Program in Early Liver Transplantation for Severe Alcoholic Hepatitis. Ann Surg 2017; 265: 20-29
• 23 Lee BP, Vittinghoff E, Hsu C. et al. Predicting Low Risk for Sustained Alcohol Use After Early Liver Transplant for Acute Alcoholic Hepatitis: The Sustained Alcohol Use Post–Liver Transplant Score. Hepatology 2019; 69: 1477-1487
• 24 Rodrigue JR, Hanto DW, Curry MP. The Alcohol Relapse Risk Assessment: A Scoring System to Predict the Risk of Relapse to Any Alcohol Use after Liver Transplant. Progress in Transplantation 2013; 23: 310-318
• 25 Farmer KC. Methods for measuring and monitoring medication regimen adherence in clinical trials and clinical practice. Clin Ther 1999; 21: 1074-1090 ; discussion 1073