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Transplant Alcohol Assessment — RACP Adult Medicine MCQ

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HardGastroenterology & HepatologyTransplant Alcohol AssessmentRACP Adult Medicine

A patient with cirrhosis and hepatocellular carcinoma within transplant criteria reports alcohol use two weeks ago and wants transplant assessment. What is the most appropriate approach?

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Correct answer: A — Use integrated medical, addiction and psychosocial assessment with an individualised relapse-prevention plan

The best answer is “Use integrated medical, addiction and psychosocial assessment with an individualised relapse-prevention plan”. Australian transplant candidacy is multidisciplinary and considers alcohol-use disorder severity, engagement, relapse risk, support and the urgency and benefit of transplantation. A fixed abstinence interval alone is neither a complete assessment nor a reason to ignore active risk. HCC progression may require timely bridging therapy while candidacy is evaluated.

Reference: Medical Journal of Australia: Alcohol-related problems and liver-transplant referral: https://www.mja.com.au/system/files/2021-09/Sup_215_7_4%20Oct.pdf