TY - JOUR
T1 - Urinary ethyl glucuronide (uEtG) as a marker for alcohol consumption in liver transplant candidates
T2 - A real-world cohort
AU - Vollmar, Johanna
AU - Stern, Franziska
AU - Lackner, Karl
AU - Mildenberger, Philipp
AU - Greif-Higer, Gertrud
AU - Mittler, Jens
AU - Darstein, Felix
AU - Foerster, Friedrich
AU - Grimm, Daniel
AU - Marquardt, Jens Uwe
AU - Schattenberg, Joern
AU - Woerns, Marcus Alexander
AU - Lang, Hauke
AU - Galle, Peter Robert
AU - Zimmermann, Tim
N1 - Publisher Copyright:
© Georg Thieme Verlag KG, Stuttgart.
Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.
PY - 2020
Y1 - 2020
N2 - Background In order to reduce alcohol relapse after liver transplantation (LT), the German national guidelines for waiting-list maintenance and organ allocation demand a minimum 6-month period of alcohol abstinence pre-LT, confirmed by measuring urinary ethyl glucuronide (uEtG). Methods Between January 2015 and June 2016, uEtG was measured at least once in 339 cirrhotic patients with an indication for LT at the University Medical Center Mainz. uEtG was measured with an enzyme-linked immunosorbent assay (ELISA) screening test (cutoff value: 500μg/L). For uEtG values ≥500μg/L, liquid chromatography-mass spectrometry (LC-MS/MS) was performed as a confirmatory assay. Data were collected prospectively in a transplant database. Results Of the 339 potential liver transplant candidates, uEtG was negative in 86.4%. Most patients were male (64.3%), with an average age of 56.42±10.1 years. In the multivariate analysis, mean corpuscular volume (p=0.001), urinary creatinine (p=0.001), gamma-glutamyl transferase (p=0.001), and hemoglobin (p=0.003) were significantly associated with a positive uEtG test result. The sensitivity of the ELISA screening test was 100% for uEtG values >2000μg/L, as confirmed by LC-MS/MS. Conclusion uEtG is an effective parameter to reveal alcohol consumption by patients on the waiting list for LT. The sensitivity of the ELISA is excellent for uEtG values >2000μg/L, for which LC-MS/MS confirmation could be omitted.
AB - Background In order to reduce alcohol relapse after liver transplantation (LT), the German national guidelines for waiting-list maintenance and organ allocation demand a minimum 6-month period of alcohol abstinence pre-LT, confirmed by measuring urinary ethyl glucuronide (uEtG). Methods Between January 2015 and June 2016, uEtG was measured at least once in 339 cirrhotic patients with an indication for LT at the University Medical Center Mainz. uEtG was measured with an enzyme-linked immunosorbent assay (ELISA) screening test (cutoff value: 500μg/L). For uEtG values ≥500μg/L, liquid chromatography-mass spectrometry (LC-MS/MS) was performed as a confirmatory assay. Data were collected prospectively in a transplant database. Results Of the 339 potential liver transplant candidates, uEtG was negative in 86.4%. Most patients were male (64.3%), with an average age of 56.42±10.1 years. In the multivariate analysis, mean corpuscular volume (p=0.001), urinary creatinine (p=0.001), gamma-glutamyl transferase (p=0.001), and hemoglobin (p=0.003) were significantly associated with a positive uEtG test result. The sensitivity of the ELISA screening test was 100% for uEtG values >2000μg/L, as confirmed by LC-MS/MS. Conclusion uEtG is an effective parameter to reveal alcohol consumption by patients on the waiting list for LT. The sensitivity of the ELISA is excellent for uEtG values >2000μg/L, for which LC-MS/MS confirmation could be omitted.
UR - http://www.scopus.com/inward/record.url?scp=85077786082&partnerID=8YFLogxK
U2 - 10.1055/a-1008-9736
DO - 10.1055/a-1008-9736
M3 - Journal articles
C2 - 31931538
AN - SCOPUS:85077786082
SN - 0044-2771
VL - 58
SP - 30
EP - 38
JO - Zeitschrift fur Gastroenterologie
JF - Zeitschrift fur Gastroenterologie
IS - 1
ER -