Parameters:
(1) duration of abstinence
(2) comorbid psychiatric disorders
(3) social support system
(4) signing of an alcohol rehabilitation contract
(5) previous failures in alcohol rehabilitation
(6) awareness of problem and willingness to change
|
Parameters
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Low Risk
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Moderate Risk
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High Risk
|
|
duration of abstinence
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> 6 months
|
1 – 6 months
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none or < 1 month
|
|
comorbid psychiatric disorders
|
none
|
relative contraindications to liver transplant
|
absolute contraindications to liver transplant
|
|
social support
|
good
|
minimal
|
poor or none
|
|
signing of contract
|
signs willingly
|
signs with some hesitation
|
refuses to sign
|
|
previous failure at abstinence
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none
|
1 or more
|
multiple failures despite health risks
|
|
awareness of problem and willingness to change
|
unaware that alcohol affected health, and willing to change
|
willing to enter into rehabilitation program
|
unwilling to rehabilitate
|
where:
• Relative psychiatric contraindications (page 1338): polysubstance abuse, moderate personality disorder, major mood disorder.
• Absolute psychiatric contraindications: severe mental retardation, chronic psychosis, overt noncompliance, severe personality disorders with refusal to be treated, dementia
• The wording of the signing of the contract has been modified to reflect a spectrum of attitude.
• The wording for awareness of problem and willingness to change was altered from the original.
A person with one or more high risk factors is unlikely to remain abstinent after receiving a liver transplant.
