Long-term outcomes of liver transplant recipients followed up in non-transplant centres: Care closer to home
| Autor: | Jatinder Hayre, Kristel Leung, Sowmya Sharma, Cynthia Tsien, Naaventhan Palaniyappan, Rachel Seoyeon Kang, Elizabeth Mowlem, Pramudi Wijayasiri, Guruprasad P. Aithal, Aloysious Aravinthan, Andrew J. Butler, Emilie Wilkes, Huey Tan, Lilia Antonova, Stephen D. Ryder, Angela C Cheung, Peter J Eddowes, William J.H. Griffiths, Indra Neil Guha, Suresh V Venkatachalapathy, Martin W. James |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Adult
medicine.medical_specialty Hub and spoke model medicine.medical_treatment Disease 030204 cardiovascular system & hematology Liver transplantation 03 medical and health sciences 0302 clinical medicine Internal medicine Health care medicine Long term outcomes Humans Cumulative incidence 030212 general & internal medicine Long-term outcomes Retrospective Studies Original Research Non-transplant centres Adult patients business.industry Graft Survival Cancer Patient survival General Medicine medicine.disease Kidney Transplantation Kidney Failure Chronic business |
| Zdroj: | Clin Med (Lond) |
| ISSN: | 1470-2118 1473-4893 |
| Popis: | 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 post-transplant 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. |
| Databáze: | OpenAIRE |
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