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Personality Disorder as a Contraindication for Liver Transplantation in Alcoholic Cirrhosis

Received September 17, 1997; revised January 30, 1998; accepted February 11, 1998. From the Department of Psychiatry, University of Oklahoma College of Medicine, Tulsa Campus; and the Department of Internal Medicine, University of Iowa College of Medicine, Iowa City. Address reprint requests to Dr. Yates, Department of Psychiatry, University of Oklahoma College of Medicine, Tulsa Campus, 2808 South Sheridan Road, Tulsa, OK 74129–1077.

Severe personality disorder has been proposed as a contraindication for liver transplantation. Seventy-three subjects with alcoholic-related liver disease were evaluated for personality disorder and followed for 6 months. The subjects with severe personality disorder had higher rates of divorce, higher rates of comorbid drug abuse or dependence, lower Weschler Adult Inventory Scale IQ estimates, and higher scores on indicators of emotional impairment. Personality disorder was not associated with a higher rate of return to alcohol use during the follow-up period. Three subjects with personality disorder underwent liver transplantation without behavioral or substance abuse complications. This study does not support routine exclusion of subjects based solely on a diagnosis of a severe personality disorder.

Key Words: personality disorder • transplants • alcoholism

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