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Long-term outcomes of liver transplant recipients followed up in non-transplant centres: Care closer to home

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.; Aravinthan, Aloysious D.

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Authors

Cynthia Tsien

Huey Tan

Sowmya Sharma

Pramudi Wijayasiri

Kristel Leung

Jatinder Hayre

Elizabeth Mowlem

Rachel Kang

Peter J. Eddowes

Emilie Wilkes

Suresh V. Venkatachalapathy

Indra N. Guha

Lilia Antonova

Angela C. Cheung

William J.H. Griffiths

Andrew J. Butler

Stephen D. Ryder

Martin W. James



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 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.

Citation

Tsien, C., Tan, H., Sharma, S., Palaniyappan, N., Wijayasiri, P., Leung, K., …Aravinthan, A. D. (2021). Long-term outcomes of liver transplant recipients followed up in non-transplant centres: Care closer to home. Clinical Medicine, 21(1), e32-e38. https://doi.org/10.7861/clinmed.2020-0609

Journal Article Type Article
Acceptance Date Oct 5, 2020
Online Publication Date Jan 21, 2021
Publication Date 2021-01
Deposit Date Oct 13, 2020
Publicly Available Date Mar 28, 2024
Journal Clinical Medicine
Print ISSN 1470-2118
Electronic ISSN 1473-4893
Publisher Royal College of Physicians
Peer Reviewed Peer Reviewed
Volume 21
Issue 1
Pages e32-e38
DOI https://doi.org/10.7861/clinmed.2020-0609
Keywords Liver transplantation; Long-term outcomes; Non-transplant centres; Hub and spoke model
Public URL https://nottingham-repository.worktribe.com/output/4961784
Publisher URL https://www.rcpjournals.org/content/clinmedicine/21/1/e32

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