Variables associated with alcohol relapse and psychosocial interventions to prevent alcohol relapse in liver transplant patients for alcoholic liver disease: A systematic review

Background and Aims: Liver transplantation is the primary treatment choice for alcohol liver disease. However, alcohol relapse is a particular problem for this population with a reported 10–50% risk. This review aims to identify alcohol relapse variables, and establish the effectiveness and explore the active ingredients of psychosocial interventions in preventing alcohol relapse, in alcohol liver disease patients pre or post-liver transplant. Methods: Mixed method systematic review involving three parallel syntheses: (1) alcohol relapse variables; (2) psychosocial intervention effectiveness; (3) active ingredients of these psychosocial interventions (i.e. a component analysis). Medline, CINAHL, EMBASE, and PsychInfo were searched in November 2013 for published literature. Grey literature searched in Web of Science, Clinical Trials Register, and Electronic Theses Online Service. Synthesis 1: Systematic search for and appraisal of prospective studies, retrospective studies, and cross-sectional surveys. Syntheses 2/3: Systematic search for and appraisal of ‘randomised controlled trials’, ‘controlled before and after studies’, and ‘before and after studies in a single group’. Results: 23 papers included: 10 cohort, 11 case–control, 1 qualitative, and 1 randomised controlled trial. Five variables out of nineteen were alcohol relapse predictors (i.e. Synthesis 1): (1)