P3791 - Substance Use History and Risk of Relapse Among Men and Women with Alcohol-Associated Cirrhosis Undergoing Transplant Evaluation

Meera Jain, MD, Lauren Carlini, MD, MSCR
University of Virginia, Charlottesville, VA

Introduction: The Stanford Integrated Psychological Assessment for Transplant (SIPAT) is a tool used to assess patient readiness for transplant, with higher scores suggesting higher psychosocial risk. The total score consists of four subdomain scores, one of which is "lifestyle & effect of substance use." This subdomain assesses the patient’s history of tobacco, alcohol, and other substance use. In prior analyses, we found no significant difference in the overall lifestyle scores of men and women with alcohol-associated cirrhosis (AC). However, overall score similarity may have obscured differences in substance use patterns. The purpose of this project was to analyze whether there are differences in specific substance use history among men and women with AC undergoing liver transplant evaluation.

Methods: A single-center, retrospective cohort study was conducted. All outpatients with AC seen in liver transplant clinic from 2015 to 2021 who had at least one SIPAT score were included. Data about substance use and/or abuse history was collected from the initial SIPAT evaluation. Fisher’s exact test was used to compare categorical data. Mann-Whitney U test was used to compare scores on each of the five questions in the lifestyle subdomain.

Results: 447 patients were included (109 women and 338 men). There were no significant differences in the scores of men and women on the five questions in the lifestyle subdomain (Table 1). Though not statistically significant, there was a trend towards higher risk of alcohol relapse for women and of other substance use relapse for men. Among patients reporting their age at first alcohol use (n=363), significantly more men reported starting before age 20 (84.3% of men vs. 67.4% of women, p< 0.0001). However, women were significantly more likely to have used alcohol within 6 months prior to evaluation (37.6% of women vs. 25.6% of men, p=0.02).

Discussion: Men and women with AC undergoing liver transplant evaluation had no significant differences in their severity of substance abuse and risk for relapse, as measured by the SIPAT. This contradicts prior studies demonstrating that men are more likely to use and abuse substances. There was a trend towards higher risk of alcohol relapse among women with AC, which is consistent with their shorter length of abstinence. Further studies are needed to determine whether these findings reflect wider trends in the AC population, or possibly, that the SIPAT does not accurately assess psychosocial risk in this patient population.


Disclosures:


Meera Jain, MD, Lauren Carlini, MD, MSCR. P3791 - Substance Use History and Risk of Relapse Among Men and Women with Alcohol-Associated Cirrhosis Undergoing Transplant Evaluation, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.