RT Journal Article
SR Electronic
T1 Long-term outcomes of liver transplant recipients followed up in non-transplant centres: Care closer to home
JF Clinical Medicine
JO Clin Med
FD Royal College of Physicians
SP e32
OP e38
DO 10.7861/clinmed.2020-0609
VO 21
IS 1
A1 Cynthia Tsien
A1 Huey Tan
A1 Sowmya Sharma
A1 Naaventhan Palaniyappan
A1 Pramudi Wijayasiri
A1 Kristel Leung
A1 Jatinder Hayre
A1 Elizabeth Mowlem
A1 Rachel Kang
A1 Peter J Eddowes
A1 Emilie Wilkes
A1 Suresh V Venkatachalapathy
A1 Indra N Guha
A1 Lilia Antonova
A1 Angela C Cheung
A1 William JH Griffiths
A1 Andrew J Butler
A1 Stephen D Ryder
A1 Martin W James
A1 Guruprasad P Aithal
A1 Aloysious D Aravinthan
YR 2021
UL http://www.rcpjournals.org/content/21/1/e32.abstract
AB 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.