Current Challenges in the Post-Transplant Care of Liver Transplant Recipients in Germany.

Autor: Herzer K; Department of Gastroenterology and Hepatology, University Hospital Essen, University Duisburg-Essen, 45147 Essen, Germany.; Knappschafts-Klinik Bad Neuenahr, 53474 Bad Neuenahr-Ahrweiler, Germany., Sterneck M; Department of Medicine, University Medical Center Hamburg Eppendorf, 20251 Hamburg, Germany., Welker MW; Department of Internal Medicine I, University Hospital Frankfurt, 60590 Frankfurt am Main, Germany., Nadalin S; Department for General, Visceral and Transplant Surgery, University Hospital Tuebingen, 72016 Tuebingen, Germany., Kirchner G; Department of Surgery, University Hospital of Regensburg, 93053 Regensburg, Germany.; Innere Medizin I, Caritaskrankenhaus St. Josef, 93053 Regensburg, Germany., Braun F; Department for Transplantation Surgery, University Hospital Kiel, 24105 Kiel, Germany., Malessa C; Department of General, Visceral and Vascular Surgery, University Hospital Jena, 07747 Jena, Germany., Herber A; Department of Gastroenterology and Rheumatology, University Hospital Leipzig, 04103 Leipzig, Germany., Pratschke J; Department of Surgery, Campus Charité Mitte/Campus Virchow-Klinikum, Charité University Medicine Berlin, 13353 Berlin, Germany.; Berlin Institute of Health, 13353 Berlin, Germany., Weiss KH; Department of Internal Medicine, University of Heidelberg, 69120 Heidelberg, Germany.; Department of Internal Medicine, Salem Medical Center, 69120 Heidelberg, Germany., Jaeckel E; Integrated Research and Treatment Centre Transplantation (IFB-Tx), Hannover Medical School, 30625 Hannover, Germany.; Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, 30625 Hannover, Germany., Tacke F; Department of Hepatology & Gastroenterology, Campus Charité Mitte/Campus Virchow-Klinikum, Charité University Medicine Berlin, 13353 Berlin, Germany.
Jazyk: angličtina
Zdroj: Journal of clinical medicine [J Clin Med] 2020 Nov 05; Vol. 9 (11). Date of Electronic Publication: 2020 Nov 05.
DOI: 10.3390/jcm9113570
Abstrakt: Improving long-term patient and graft survival after liver transplantation (LT) remains a major challenge. Compared to the early phase after LT, long-term morbidity and mortality of the recipients not only depends on complications immediately related to the graft function, infections, or rejection, but also on medical factors such as de novo malignancies, metabolic disorders (e.g., new-onset diabetes, osteoporosis), psychiatric conditions (e.g., anxiety, depression), renal failure, and cardiovascular diseases. While a comprehensive post-transplant care at the LT center and the connected regional networks may improve outcome, there is currently no generally accepted standard to the post-transplant management of LT recipients in Germany. We therefore described the structure and standards of post-LT care by conducting a survey at 12 German LT centers including transplant hepatologists and surgeons. Aftercare structures and form of cost reimbursement considerably varied between LT centers across Germany. Further discussions and studies are required to define optimal structure and content of post-LT care systems, aiming at improving the long-term outcomes of LT recipients.
Competing Interests: K.H. received speaker’s honoraria, travel grants, research funding, and/or membership of advisory boards from Novartis, Astellas, Chiesi, Roche, Biotest, and BMS; S.N. received speaker’s honoraria, travel grants, research funding, and/or membership of advisory boards from Novartis and Astellas; M.-W.W. received fees for consultancies and as a speaker from AbbVie, Akcea, Amgen, Bayer, BMS, Gilead, Hexal, Novartis, and Roche. Travel support was provided by AbbVie, Astellas, Bayer, BMS, Novartis, Janssen, and Roche. M.S. received speaker’s honoraria, travel grants, research funding, and/or membership of advisory boards from Novartis; received travel grants from Biotest, Astellas, and Roche; and received speaker’s honoraria and travel grants from Biotest. All other authors declare no conflict of interest related to this manuscript.
Databáze: MEDLINE
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