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Jiten P. Kothadia, MD: Using S-DAT to Reduce Alcohol Liver Disease Relapses

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The study author discusses the clinical implications of his team's assessment into a risk factor score for alcohol relapse among post-transplant patients with ALD.

As previously covered during the American College of Gastroenterology (ACG) 2023 Annual Scientific Meeting in Vancouver, BC, the Social Determinant Acuity Tool (S-DAT) was associated with significant sensitivity that which indicates a capability to accurately identify patients with alcohol liver disease at greater or lower risk of alcohol relapse post-liver transplant.1

While the findings are of interest to the hepatic care community—no less at a time when alcohol liver disease is surging in the US—there’s more to derive from this first iteration into research.

In the second segment of an interview with HCPLive at ACG 2023, investigator Jiten P. Kothadia, MD, of the University of Tennessee Health Science Center, discussed the preeminent takeaways from his team’s research into the S-DAT scoring system: the tool may help clinicians identify patients with alcohol liver disease who are at lower risk of alcohol relapse, and help prioritize them for an early transplant.

Kothadia said this would theoretically benefit to expedite efficient and timely intervention for patients who are particularly sick from their liver disease or lack proper care resources beyond a transplant.

“And at the same time, those who you had identified a risk factor (on S-DAT), then you can intervene before a transplant to show them a suitable healthy path,” Kothadia said. “Then in post-transplant, you can keep a close eye on this patient, depending on their risk score.”

Kothadia additionally sees a benefit in aiding his peers’ allocation of time and resources dedicated to treating alcohol liver disease—an emerging public health crisis that which clinicians have previously told HCPLive is lacking adequate staffing and treatment options to curb.2

“It will also be helpful in how many times this kind of patient should be seen by psychologists or psychiatrists, or just monitored more closely, compared to other patients,” he said.

Though this trial was limited by the single-center setting and retrospective analysis method, Kothadia said it’s the implementation of a multifactorial tool that which considers all the individual components of alcohol relapse risk in alcohol liver disease patients that which provides interesting fodder for good research—and opportunities for his peers to implement it in their own practices.

“And there are so many factors that needs to be considered to provide a protocol for comprehensive care that ultimately provides the best health care outcome, improves the long-term survival and the quality of life. Ultimately, that is the goal for any intervention, whether it's a transplant or any medicine: you want to improve quality of life and improve the patient survival.

References

  1. Kothadia JP, Dash A, Rong J, Liu TY, et al. Predicting Low-Risk for Alcohol Relapse Within One Year Post Liver Transplant for Alcoholic Liver Disease: S-DAT Score. Paper presented at: ACG 2023 Annual Scientific Meeting. Vancouver, BC, Canada. October 20 – 25, 2023.
  2. Kunzmann K. Relentless: The Concurrent Alcohol Abuse, Liver Disease Epidemics in the US. HCPLive. Published October 3, 2023. https://www.hcplive.com/view/concurrent-alcohol-abuse-liver-disease-epidemics-us

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