A multidisciplinary clinic model for alcohol use disorder after liver transplantation: Implementation and early outcomes of the LIFT Clinic.

Abstract

Return to alcohol use after liver transplantation is a major clinical challenge, with limited structured approaches for prevention and management in the post-transplant setting. To address gaps in post-transplant alcohol use disorder (AUD) care, we established the Long-term Individualized Follow-up after Transplant (LIFT) Clinic, a co-located multidisciplinary program integrating hepatology, psychiatry, social work, and health navigation. We conducted a retrospective cohort study of 113 patients referred between December 2022 and December 2024. Fifty patients attended at least one clinic visit, including 25 referred for prevention and 25 for management. Patients were followed longitudinally as part of routine post-transplant care. Among patients in the prevention track, the median time to first visit was 4.2 months post-transplant, 56% received medications for AUD, and one patient (4%) experienced two brief episodes of return to alcohol use. Among patients in the management track, 84% received medications for AUD; at the end of follow-up, 28% achieved sobriety, 60% reduced alcohol use, and 12% showed no reduction. Early implementation challenges included high non-attendance, which improved following operational changes. These findings demonstrate the successful implementation of a patient-centered, integrated care model for managing AUD after liver transplantation while highlighting patient engagement as an important early implementation challenge and provide a practical model for multidisciplinary post-transplant AUD care at other transplant centers.