78 research outputs found

    Liver transplant and hepatitis C in methadone maintenance therapy: a case report

    Get PDF
    Methadone maintenance therapy for the treatment of opioid dependence continues to carry a social stigma. Until recently, patients on methadone were not considered for liver transplantation. We describe the first case of a patient on methadone who received a liver transplant for end stage liver disease and was successfully treated for recurrent hepatitis C. More than five years post transplant and three years post viral clearance, the patient continues to do well and is stable on low-dose methadone. This case emphasizes the need to reconsider the non-evidence based policy adopted by transplant centers that require methadone maintenance therapy patients to stop methadone prior to consideration for transplant evaluation

    Psychiatric disorders as risk factors for adverse medical outcomes after solid organ transplantation

    No full text
    PURPOSE OF REVIEW: Given that the prevalence of psychiatric disorders in transplant candidates and recipients is substantially higher than in the general population, and that linkages between psychiatric disorders and medical outcomes for nontransplant-related diseases have been established, it is important to determine whether psychiatric disorders predict posttransplant medical outcomes. RECENT FINDINGS: Most research has focused on the association between depression (both pretransplant and posttransplant) and posttransplant mortality. Some research has examined transplant-related morbidity outcomes, such as graft rejection, posttransplant malignancies, and infection. However, methodological limitations make it difficult to compare existing studies in this literature directly. Overall, the studies presented in this review indicate that psychiatric distress occurring in the early transplant aftermath bears a stronger relationship to morbidity and mortality outcomes than psychiatric distress occurring before transplant. SUMMARY: The literature on the impact of psychiatric conditions on the morbidity and mortality of solid organ transplant recipients remains inconclusive. More research is needed in order to investigate these associations among a broader range of psychiatric predictors, morbidity outcomes, and recipient populations. Until evidence suggests otherwise, we recommend frequent monitoring of psychiatric symptoms during the first year after transplantation to aid in early identification and treatment during this critical period of adjustment. © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins

    Gastrointestinal Disorders

    No full text
    Diseases of the gastrointestinal (GI) system are prevalent and are frequently associated with distress and psychiatric disorders, which may cause, exacerbate, or be a reaction to these disorders (Jones et al. 2007; Sandler et al. 2002). In this chapter, we review the use of psychotropic medications in the treatment of GI disorder symptoms and comorbid psychopathology, potential interactions between GI medications and psychotropic agents, risks of prescribing psychiatric medications in the presence of particular GI disorders, and alterations in the pharmacokinetics of psychotropic drugs induced by GI disorders (e.g., hepatic failure, short bowel syndrome). The chapter is organized first by organ system and then by specific GI disorder
    corecore