What is your clinical pathway when a transplant candidate reports abstinence but has a positive phosphatidylethanol (PeTH), including how you confirm results and decide on addiction-medicine involvement and listing implications?

We address the discrepancy directly with the patient. If the liver disease is moderate, we decline the patient as a candidate and require enrollment in an AUD treatment plan along with monthly Peth testing in order to eventually list. Medicines to prevent cravings are offered at hospital discharge. ...

We address discordant positive PEth in a structured, non-punitive path. We involve addiction medicine and a social worker to intensify the assessment. Listing decisions are as per multidisciplinary team judgment.