Psychiatric consultations in pre-orthoptic liver transplantation patients with substance use disorders: focus on timing of cessation and referral and retention by community service

Introduction: In Italy, 6 months of abstinence from alcohol/substances are required before OLT, evidence
for this recommendation remaining controversial. No standard approach linking abstinence duration at the
index psychiatric pre-OLT evaluation to referral to Community Services is followed.
Aims: To report data of the Modena Consultation-Liaison Psychiatric Service (MCLPS) for pre-OLT patients
with Substance Use Disorders (SUDs), and to evaluate patients’ concordance with referrals.
Methods: Case-control study. Data source: database of MCLPS. Psychiatric evaluations pre-OLT from
01/01/2008 to 31/12/2013 were extracted. Patients were controls if they had a SUD and abstinent for more
than 6 months; cases if they had a SUD with less than 6 months of abstinence. Chi-squared analysis was
performed with STATA 13.0.
Results: 515 consultations were requested for 309 pre-OLT patients, 36.3% (N=112) of patients had a
current or past SUD. Controls were 80 (71.3%), while cases - who had stopped use less than 6 months
before the consultation, or were still using- were 20 (17.9%). 52.5% of controls (N=42) and 85.0% of cases
(N=17) were referred to community services (Chi 5.71; p=0.02). 70.0% of cases (N=14) and 33.6% of
controls (N=27) were seen at least twice (Chi 7.22; p=0.01). 16.7% (N=2) of cases and 23.5 % (N=4) of
controls referred to community services reported concordance with Consultant’s recommendation at reassessment,
a non-significant difference with cases (Chi 0.00; p=1.00).
Conclusions: Consistently with previously research in this field, no difference of concordance with
recommendations emerged between patients with SUD with different duration of abstinence.