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| 1 | Liver transplantation and alcoholic liver disease:History,controversies,and considerations显示文摘Alcohol consumption accounts for 3.8% of annual global mortality worldwide, and the majority of these deaths are due to alcoholic liver disease(ALD), mainly alcoholic cirrhosis. ALD is one of the most common indications for liver transplantation(LT). However, it remains a complicated topic on both medical and ethical grounds, as it is seen by many as a 'self-inflicted disease'. One of the strongest ethical arguments against LT for ALD is the probability of relapse. However, ALD remains a common indication for LT worldwide. For a patient to be placed on an LT waiting list, 6 mo of abstinence must have been achieved for most LT centers. However, this '6-mo rule' is an arbitrary threshold and has never been shown to affect survival, sobriety, or other outcomes. Recent studies have shown similar survival rates among individuals who undergo LT for ALD and those who undergo LT for other chronic causes of end-stage liver disease. There are specific factors that should be addressed when evaluating LT patients with ALD because these patients commonly have a high prevalence of multisystem alcohol-related changes. Risk factors for relapse include the presence of anxiety or depressive disorders, short pre-LT duration of sobriety, and lack of social support. Identification of risk factors and strengthening of the social support system may decrease relapse among these patients. Family counseling for LT candidates is highly encouraged to prevent alcohol consumption relapse. Relapse has been associated with unique histopathological changes, graft damage, graft loss, and even decreased survival in some studies. Research has demonstrated the importance of a multidisciplinary evaluation of LT candidates. Complete abstinence should be attempted to overcome addiction issues and to allow spontaneous liver recovery. Abstinence is the cornerstone of ALD therapy. Psychotherapies, including 12-step facilitation therapy, cognitive-behavioral therapy, and motivational enhancement therapy, help support abstinence. Nutritional therapy helps to reverse muscle wasting, weight loss, vitamin deficiencies, and trace element deficiencies associated with ALD. For muscular recovery, supervised physical activity has been shown to lead to a gain in muscle mass and improvement of functional activity. Early LT for acute alcoholic hepatitis has been the subject of recent clinical studies, with encouraging results in highly selected patients. The survival rates after LT for ALD are comparable to those of patients who underwent LT for other indications. Patients that undergo LT for ALD and survive over 5 years have a higher risk of cardiorespiratory disease, cerebrovascular events, and de novo malignancy. | Claudio Augusto Marroni Alfeu de Medeiros Fleck Jr Sabrina Alves Fernandes Lucas Homercher Galant Marcos Mucenic Mario Henrique de Mattos Meine Guilherme Mariante-Neto Ajacio Bandeira de Mello Brandao | 2018 | World Journal of Gastroenterology2018，24，26： | 7 |
| 2 | Aripiprazole augmentation in treatment-resistant bipolar depression: early response and development of akathisia 显示文摘 | KEMP DE GILMER WS FLECK J | 2007 | Prog Neuropsychopharmacol Biol Psychiatry2007，31，2： | 1 |
| 3 | The Arabidopsis mutant sleepylgar2-1 protein promotes plant growth by increasing the affinity of the SCFSL YI E3 ubiquitin ligase for DELLA protein substrates显示文摘 | Fu X Richards DE Fleck B | 2004 | Plant Cell2004，16，6： | 1 |
| 4 | Impulsivity across the course of bipolar disorder 显示文摘 | Strakowski SM Fleck DE DelBello MP | 2010 | Bipolar Disord2010，12，3： | 1 |
| 5 | Effects of resistance training on cytokines 显示文摘 | de Salles BF S~mao R Fleck SJ et a | 2010 | Int J Sports Med2010，31，7： | 1 |
| 6 | Safety and tolerability of quetiapine in the treatment of acute mania in bipolar disorder显示文摘 | Adler CM Fleck DE Brecher M | 2007 | J Affect Disord2007，1001，： | 1 |
| 7 | Aripiprazole augmenta- tion in treatmentresistant bipolar depression: early response and development of akathisia显示文摘 | Kemp DE Gilmer WS Fleck J | 2007 | Prog Neuropsychopharmacol Biol Psychiatry2007，31，2： | 1 |
| 8 | Subsyndromal depression: an impact on quality of life?显示文摘 | da Silva Lima AF de Almeida Fleck MP | 2007 | J Affect Disord2007，100，123： | 1 |
| 9 | Impact of creatinine values on MELD scores in male and fe- male candidates for liver transplantation显示文摘 | Mariante-Neto G M Marroni C P de Medeiros Fleck Junior A | 2013 | Ann hepatol2013，12，3： | 1 |
| 10 | Depression as a determinant of quality of life in patients with chronic disease: data from Brazil显示文摘 | Cruz LN de Almeida Fleck MP Polanczyk CA | 2010 | Social psychiatry and psychiatric epidemiology2010，45，10： | 1 |
| 11 | Wisconsin Card Sorting Test performance in bipolar disorder:effects of mood state and early course显示文摘 | Fleck DE Shear PK Madore M | 2008 | Bipolar Disord2008，10，： | 1 |
| 12 | Factors associated with medication adherence in African American and white patients with bipolar disorder显示文摘 | FLECK DE KECK PE COREY KB | 2005 | The Journal of Clinical Psychiatry2005，66，5： | 1 |
| 13 | Unplanned pregnancies in adolescents with bipolar disorder显示文摘 | Heffner JL DelBello MP Fleck DE | 2012 | Am J Psychiatry2012，169，12： | 1 |
| 14 | Inhibitory control in ob- sessive-compulsive disorder显示文摘 | Krikorian R Zimmerman ME Fleck DE | 2004 | Brain Cognition2004，54，3： | 1 |
| 15 | Safety and tolera- bility of quetiapine in the treatment of acute mania in bipolar disorder显示文摘 | ADLER CM FLECK DE BRECHER M | 2007 | J Affective Disord2007，100，1： | 1 |
| 16 | Inhibitory control in ob-sessive-compulsive disorder 显示文摘 | Krikorian R Zimmerman ME Fleck DE | 2004 | Brain Cogn2004，54，3： | 1 |
| 17 | Characterizing Im-pulsivity in Mania显示文摘 | Strakowski SM Fleck DE DelBello MP | 2009 | Bipolar Disord2009，11，： | 1 |
| 18 | Impulsivity across thecourse of bipolar disorder显示文摘 | Strakowski SM Fleck DE DelBello MP | 2010 | Bipolar Disord2010，12，： | 1 |
| 19 | Concord grape juice supplementation and neurocognitive function in human aging显示文摘 | Krikorian R Boespflug EL Fleck DE Stein AL Wightman JD Shidler MD | 2012 | J Agric Food Chem2012，60，23： | 1 |
| 20 | A longitudinal func- tional connectivity analysis of the amygdala in bipolar I disorder across mood states显示文摘 | Cerullo MA Fleck DE Eliassen JC | 2012 | Bipolar Disord2012，14，2： | 1 |
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