1. Long-term outcomes of liver transplant recipients followed up in non-transplant centres: Care closer to home.
- Author
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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., and Aithal, Guruprasad P.
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HOSPITALS , *LIVER transplantation , *TRANSPLANTATION of organs, tissues, etc. , *HOME environment , *TREATMENT effectiveness , *DISEASE incidence , *RETROSPECTIVE studies , *DESCRIPTIVE statistics - 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]
- Published
- 2021
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