Improved Survival in Liver Transplant Patients Receiving Prolonged-release Tacrolimus-based Immunosuppression in the European Liver Transplant Registry (ELTR): An Extension Study

被引：11

作者：

Adam, Rene ^{[1
]}

Karam, Vincent ^{[1
]}

Cailliez, Valerie ^{[1
]}

Trunecka, Pavel ^{[2
]}

Samuel, Didier ^{[1
]}

Tisone, Giuseppe ^{[3
]}

Nemec, Petr ^{[4
]}

Soubrane, Olivier ^{[5
]}

Schneeberger, Stefan ^{[6
]}

Gridelli, Bruno ^{[7
]}

Bechstein, Wolf O. ^{[8
]}

Risaliti, Andrea ^{[9
]}

Line, Pal-Dag ^{[10
]}

Vivarelli, Marco ^{[11
]}

Rossi, Massimo ^{[12
]}

Pirenne, Jacques ^{[13
]}

Klempnauer, Jurgen L. ^{[14
]}

Rummo, Aleh ^{[15
]}

Di Benedetto, Fabrizio ^{[16
]}

Zieniewicz, Krzysztof ^{[17
]}

Troisi, Roberto ^{[18
]}

Paul, Andreas ^{[19
]}

Vali, Toomas ^{[20
]}

Kollmar, Otto ^{[21
]}

Boudjema, Karim ^{[22
]}

Hoti, Emir ^{[23
]}

Colledan, Michele ^{[24
]}

Pratschke, Johan ^{[25
]}

Lang, Hauke ^{[26
]}

Popescu, Irinel ^{[27
]}

Ericzon, Bo-Goran ^{[28
]}

Strupas, Kestutis ^{[29
]}

De Simone, Paolo ^{[30
]}

Kochs, Eberhard ^{[31
]}

Heyd, Bruno ^{[32
]}

Gugenheim, Jean ^{[33
]}

Pinna, Antonio D. ^{[34
]}

Bennet, William ^{[35
]}

Kazimi, Mirjalal ^{[36
]}

Bachellier, Philippe ^{[37
]}

Wigmore, Stephen J. ^{[38
]}

Rasmussen, Allan ^{[39
]}

Clavien, Pierre-Alain ^{[40
]}

Hidalgo, Ernest ^{[41
]}

O'Grady, John G. ^{[42
]}

Zamboni, Frausto ^{[43
]}

Kilic, Murat ^{[44
]}

Duvoux, Christophe ^{[45
]}

机构：

[1] Univ Paris Sud, Paul Brousse Hosp, AP HP, INSERM U935,Hepatobiliary Ctr, Villejuif, France

[2] Inst Clin & Expt Med IKEM, Transplant Ctr, Prague, Czech Republic

[3] Univ Roma Tor Vergata, Liver Transplant Unit, Tor Vergata Polyclin, Rome, Italy

[4] Ctr Cardiovasc Surg & Transplantat, Brno, Czech Republic

[5] Beaujon Hosp, AP HP, Dept Digest Surg, Clichy, France

[6] Innsbruck Med Univ, Dept Visceral Transplant & Thorac Surg, Innsbruck, Austria

[7] Mediterranean Inst Transplantat & Adv Specialized, Palermo, Sicily, Italy

[8] Goethe Univ Hosp & Clin, Dept Gen & Visceral Surg, Frankfurt, Germany

[9] Univ Hosp Udine, Dept Surg, Liver Transplant Unit, Udine, Italy

[10] Oslo Univ Hosp, Dept Transplantat Med, Oslo, Norway

[11] Polytech Univ Marche, Dept Expt & Clin Med, Hepatobiliary & Abdominal Transplantat Surg, Ancona, Italy

[12] Umberto 1 Policlin Rome, Organ Transplant Unit Paride Stefanini, Dept Gen Surg, Rome, Italy

[13] Univ Hosp Leuven, Abdominal Transplant Surg, Leuven, Belgium

[14] Hannover Med Sch, Dept Gen Visceral & Transplantat Surg, Hannover, Germany

[15] Republican Sci & Pract Ctr RSPC Organ & Tissue Tr, Minsk, BELARUS

[16] Univ Modena & Reggio Emilia, Hepatopancreato Biliary Surg & Liver Transplantat, Modena, Italy

[17] Med Univ Warsaw, Dept Gen Transplant & Liver Surg, Warsaw, Poland

[18] Ghent Univ Hosp, Dept Gen Hepatobiliary & Liver Transplantat Surg, Med Sch, Ghent, Belgium

[19] Univ Hosp Essen, Dept Gen & Transplant Surg, Essen, Germany

[20] Tartu Univ Hosp, Surg Clin, Tartu, Estonia

[21] Univ Med Ctr Gottingen, Dept Gen Visceral & Pediat Surg, Gottingen, Germany

[22] Univ Hosp Rennes, Pontchaillou Hosp, Dept Visceral Surg, Rennes, France

[23] St Vincents Hosp, Liver Unit, Dublin, Ireland

[24] Pope John XXIII Hosp, Dept Surg, Bergamo, Italy

[25] Charite Campus Virchow Klinikum CVK, Dept Gen Visceral & Transplantat Surg, Berlin, Germany

[26] Johannes Gutenberg Univ Mainz, Gen Visceral & Transplantat Surg Clin, Mainz, Germany

[27] Univ Med & Pharm Carol Davila, Fundeni Clin Inst, Dept Surg & Liver Transplantat, Bucharest, Romania

[28] Karolinska Univ Hosp, Dept Transplantat Surg, Huddinge, Sweden

[29] Vilnius Univ Hosp Santaros Klinikos, Dept Gastroentrol Nephrol & Surg, Vilnius, Lithuania

[30] Univ Pisa, Hepatobiliary Surg & Liver Transplantat Unit, Med Sch Hosp, Pisa, Italy

[31] Univ Hosp, Surg Clin & Polyclin, Klinikum Rechts Isar Munich, Munich, Germany

[32] Univ Franche Comte, Univ Hosp Besancon, Dept Visceral Surg, Besancon, France

[33] Archet 2 Hosp, Dept Digest Surg, Nice, France

[34] Univ Bologna, Transplant & HPB Inst, Bologna, Italy

[35] Sahlgrens Univ Hosp, Surg Dept, Transplantat & Liver Surg Unit, Gothenburg, Sweden

[36] Cent Hosp Oil Workers, Surg & Organ Transplantat Ctr, Baku, Azerbaijan

[37] Univ Hosp Strasbourg, Hosp Hautepierre, Dept Surg, Strasbourg, France

[38] Univ Edinburgh, Liver Transplantat Unit, Royal Infirm, Edinburgh, Midlothian, Scotland

[39] Univ Hosp Copenhagen, Dept Surg & Transplantat, Copenhagen, Denmark

[40] Univ Hosp Zurich, Dept Visceral & Transplant Surg, Zurich, Switzerland

[41] St James & Seacroft Univ Hosp, Leeds, W Yorkshire, England

[42] Kings Coll Hosp London, Liver Unit, London, England

[43] Hosp G Brotzu, Dept Gen Surg & Transplantat, Cagliari, Italy

[44] Kent Hosp, Izmir, Turkey

[45] Univ Hosp Henri Mondor, Dept Hepatol & Gastroenterol, Creteil, France

来源：

TRANSPLANTATION | 2019年 / 103卷 / 09期

关键词：

TWICE-DAILY TACROLIMUS; ONCE-DAILY TACROLIMUS; RISK-FACTORS; RECIPIENTS; CONVERSION; NONADHERENCE; VARIABILITY; MEDICATION; REJECTION; ADHERENCE;

D O I：

10.1097/TP.0000000000002700

中图分类号：

R392 [医学免疫学]; Q939.91 [免疫学];

学科分类号：

100102 ;

摘要：

Background. We compared, through the European Liver Transplant Registry, long-term liver transplantation outcomes with prolonged-release tacrolimus (PR-T) versus immediate-release tacrolimus (IR-T)-based immunosuppression. This retrospective analysis comprises up to 8-year data collected between 2008 and 2016, in an extension of our previously published study. Methods. Patients with <1 month follow-up were excluded; patients were propensity score matched for baseline characteristics. Efficacy measures included: univariate/multivariate analyses of risk factors influencing graft/patient survival up to 8 years posttransplantation, and graft/patient survival up to 4 years with PR-T versus IR-T. Overall, 13 088 patients were included from 44 European centers; propensity score-matched analyses comprised 3006 patients (PR-T: n = 1002; IR-T: n = 2004). Results. In multivariate analyses, IR-T-based immunosuppression was associated with reduced graft survival (risk ratio, 1.49; P = 0.0038) and patient survival (risk ratio, 1.40; P = 0.0215). There was improvement with PR-T versus IR-T in graft survival (83% versus 77% at 4 y, respectively; P = 0.005) and patient survival (85% versus 80%; P = 0.017). Patients converted from IR-T to PR-T after 1 month had a higher graft survival rate than patients receiving IR-T at last follow-up (P < 0.001), or started and maintained on PR-T (P = 0.019). One graft loss in 4 years was avoided for every 14.3 patients treated with PR-T versus IR-T. Conclusions. PR-T-based immunosuppression might improve long-term outcomes in liver transplant recipients than IR-T-based immunosuppression.

引用

页码：1844 / 1862

页数：19

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