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When demand exceeds supply: Liver transplantation due to alcohol use disorder in Austria

BACKGROUND: Alcohol use disorder (AUD) is associated with a high prevalence rate and causes a significant burden on health systems globally. The most severe condition associated with AUD is end-stage alcohol-related liver disease (ARLD), for which liver transplantation (LTX) is the only curative the...

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Autores principales: Listabarth, Stephan, Gmeiner, Andrea, Pruckner, Nathalie, Vyssoki, Sandra, Wippel, Andreas, König, Daniel
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Vienna 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7732788/
https://www.ncbi.nlm.nih.gov/pubmed/33141424
http://dx.doi.org/10.1007/s40211-020-00364-8
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author Listabarth, Stephan
Gmeiner, Andrea
Pruckner, Nathalie
Vyssoki, Sandra
Wippel, Andreas
König, Daniel
author_facet Listabarth, Stephan
Gmeiner, Andrea
Pruckner, Nathalie
Vyssoki, Sandra
Wippel, Andreas
König, Daniel
author_sort Listabarth, Stephan
collection PubMed
description BACKGROUND: Alcohol use disorder (AUD) is associated with a high prevalence rate and causes a significant burden on health systems globally. The most severe condition associated with AUD is end-stage alcohol-related liver disease (ARLD), for which liver transplantation (LTX) is the only curative therapy. However, the determination of key epidemiologic figures of both conditions is limited by several difficulties and challenges. Therefore, the goal of this paper is to discuss different epidemiological models to estimate AUD and ARLD prevalence, and compare the results of these models with LTX data. METHODS: A literature search for epidemiological models estimating the prevalence of AUD and associated secondary diseases was conducted. Identified approaches are discussed and recalculated, applying the newest available data for Austria. The thus estimated numbers were, in a further step, set in relation to the national LTX statistics. RESULTS: Besides health survey-based estimations and models based on economic data, estimations based on the mortality of ARLD (Jellinek formula) were identified. Depending on the prediction scenario, the calculated rates of prevalence of AUD ranged between 4.1% and 10.1% for the population aged older than 15 years. Furthermore, while the prevalence of secondary diseases due to AUD is high, only a marginal proportion (about 4%) of end-stage ARLD patients receive a new organ. CONCLUSION: These results suggest that the prevalence of AUD and associated diseases remain underestimated. Furthermore, a pronounced discrepancy between the number of ARLD deaths and the number of LTXs due to ARLD, and distinct regional differences in the supply of LTXs, were found.
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spelling pubmed-77327882020-12-17 When demand exceeds supply: Liver transplantation due to alcohol use disorder in Austria Listabarth, Stephan Gmeiner, Andrea Pruckner, Nathalie Vyssoki, Sandra Wippel, Andreas König, Daniel Neuropsychiatr Original Article BACKGROUND: Alcohol use disorder (AUD) is associated with a high prevalence rate and causes a significant burden on health systems globally. The most severe condition associated with AUD is end-stage alcohol-related liver disease (ARLD), for which liver transplantation (LTX) is the only curative therapy. However, the determination of key epidemiologic figures of both conditions is limited by several difficulties and challenges. Therefore, the goal of this paper is to discuss different epidemiological models to estimate AUD and ARLD prevalence, and compare the results of these models with LTX data. METHODS: A literature search for epidemiological models estimating the prevalence of AUD and associated secondary diseases was conducted. Identified approaches are discussed and recalculated, applying the newest available data for Austria. The thus estimated numbers were, in a further step, set in relation to the national LTX statistics. RESULTS: Besides health survey-based estimations and models based on economic data, estimations based on the mortality of ARLD (Jellinek formula) were identified. Depending on the prediction scenario, the calculated rates of prevalence of AUD ranged between 4.1% and 10.1% for the population aged older than 15 years. Furthermore, while the prevalence of secondary diseases due to AUD is high, only a marginal proportion (about 4%) of end-stage ARLD patients receive a new organ. CONCLUSION: These results suggest that the prevalence of AUD and associated diseases remain underestimated. Furthermore, a pronounced discrepancy between the number of ARLD deaths and the number of LTXs due to ARLD, and distinct regional differences in the supply of LTXs, were found. Springer Vienna 2020-11-03 2020 /pmc/articles/PMC7732788/ /pubmed/33141424 http://dx.doi.org/10.1007/s40211-020-00364-8 Text en © The Author(s) 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
spellingShingle Original Article
Listabarth, Stephan
Gmeiner, Andrea
Pruckner, Nathalie
Vyssoki, Sandra
Wippel, Andreas
König, Daniel
When demand exceeds supply: Liver transplantation due to alcohol use disorder in Austria
title When demand exceeds supply: Liver transplantation due to alcohol use disorder in Austria
title_full When demand exceeds supply: Liver transplantation due to alcohol use disorder in Austria
title_fullStr When demand exceeds supply: Liver transplantation due to alcohol use disorder in Austria
title_full_unstemmed When demand exceeds supply: Liver transplantation due to alcohol use disorder in Austria
title_short When demand exceeds supply: Liver transplantation due to alcohol use disorder in Austria
title_sort when demand exceeds supply: liver transplantation due to alcohol use disorder in austria
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7732788/
https://www.ncbi.nlm.nih.gov/pubmed/33141424
http://dx.doi.org/10.1007/s40211-020-00364-8
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