학술논문
Long-term outcomes of liver transplant recipients followed up in non-transplant centres: Care closer to home.
Document Type
Article
Author
Tsien, Cynthia; Tan, Huey; Sharma, Sowmya; Palaniyappan, Naaventhan; Wijayasiri, Pramudi; Leung, Kristel; Hayre, Jatinder; Mowlem, Elizabeth; Kang, Rachel; Eddowes, Peter J.; Wilkes, Emilie; Venkatachalapathy, Suresh V.; Guha, Indra N.; Antonova, Lilia; Cheung, Angela C.; Griffiths, William J. H.; Butler, Andrew J.; Ryder, Stephen D.; James, Martin W.; Aithal, Guruprasad P.
Source
Subject
*HOSPITALS
*LIVER transplantation
*TRANSPLANTATION of organs, tissues, etc.
*HOME environment
*TREATMENT effectiveness
*DISEASE incidence
*RETROSPECTIVE studies
*DESCRIPTIVE statistics
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Language
ISSN
1470-2118
Abstract
Introduction Increasing rates of liver transplantation and improved outcomes have led to greater numbers of transplant recipients followed up in non-transplant centres. Our aim was to document long-term clinical outcomes of liver transplant recipients managed in this 'hub-and-spoke' healthcare model. Methods A retrospective analysis of all adult patients who underwent liver transplantation between 1987 and 2016, with posttransplant follow-up in two non-transplant centres in the UK (Nottingham) and Canada (Ottawa), was performed. Results The 1-, 5-, 10- and 20-year patient survival rates were 98%, 95%, 87% and 62%, and 100%, 96%, 88% and 62% in the Nottingham and Ottawa groups, respectively (p=0.87). There were no significant differences between the two centres in 1-, 5-, 10- and 20-year cumulative incidence of death-censored graft-survival (p=0.10), end-stage renal disease (p=0.29) or de novo cancer (p=0.22). Nottingham had a lower incidence of major cardiovascular events (p=0.008). Conclusion Adopting a new model of healthcare provides a means of delivering post-transplant patient care close to home without compromising patient survival and long-term clinical outcomes. [ABSTRACT FROM AUTHOR]