scholarly journals Profile of a Liver Transplant Follow-Up Clinic in a Nontransplant Canadian Urban Centre

1997 ◽  
Vol 11 (3) ◽  
pp. 235-238 ◽  
Author(s):  
R Bazylewski ◽  
BG Rosser ◽  
A Cohen ◽  
KDE Kaita ◽  
GY Minuk
Keyword(s):  
Liver Transplant ◽  
First Year ◽  
Transplant Recipients ◽  
Urban Centre ◽  
Care Clinic ◽  
Transplant Centre ◽  
Transplant Patients ◽  
Ambulatory Care Clinic ◽  
Liver Transplant Recipients

Care of the growing number of liver transplant recipients will increasingly fall on the referring centres. Thus, there is a need to define more clearly the demographic, clinical and laboratory profiles of liver transplant recipients, particularly in the setting of a centre where a liver transplantation program does not exist. The present study documented these features in 37 patients attending an adult ambulatory care clinic in an urban, nonliver transplant centre. Mean ± SD age of the study population was 44±11.9 years. Twenty-one patients (57%) were male. Annual enrolment in the clinic increased from three patients at the completion of the clinic's first year (1988) to 16 patients in the final year of the study (1993). Time between the transplantation procedure and the patient's return to the referring centre decreased from a mean of 12 weeks in 1988 to four weeks in 1993. During those seven years no patient required an unscheduled return to the transplant centre for surgical complications or problems associated with immunosuppressive therapy. In conclusion, these data provide a profile of liver transplant patients attending a nonliver transplant centre for follow-up and support the concept that nontransplant centres are capable of providing safe and, in terms of travel, less expensive care for liver transplant recipients.

scholarly journals Burden and Timeline of Infectious Diseases in the First Year After Solid Organ Transplantation in the Swiss Transplant Cohort Study

2020 ◽  
Vol 71 (7) ◽  
pp. e159-e169 ◽  
Author(s):  
Christian van Delden ◽  
Susanne Stampf ◽  
Hans H Hirsch ◽  
Oriol Manuel ◽  
Pascal Meylan ◽  
...  
Keyword(s):  
Cohort Study ◽  
Liver Transplant ◽  
Digestive Tract ◽  
First Year ◽  
Solid Organ ◽  
Transplant Recipients ◽  
Opportunistic Pathogens ◽  
Kidney Transplant Recipients ◽  
Liver Transplant Recipients

Abstract Background The burden and timeline of posttransplant infections are not comprehensively documented in the current era of immunosuppression and prophylaxis. Methods In this prospective study nested within the Swiss Transplant Cohort Study (STCS), all clinically relevant infections were identified by transplant–infectious diseases physicians in persons receiving solid organ transplant (SOT) between May 2008 and December 2014 with ≥12 months of follow-up. Results Among 3541 SOT recipients, 2761 (1612 kidney, 577 liver, 286 lung, 213 heart, and 73 kidney-pancreas) had ≥12 months of follow-up; 1520 patients (55%) suffered 3520 infections during the first year posttransplantation. Burden and timelines of clinically relevant infections differed between transplantations. Bacteria were responsible for 2202 infections (63%) prevailing throughout the year, with a predominance of Enterobacteriaceae (54%) as urinary pathogens in heart, lung, and kidney transplant recipients, and as digestive tract pathogens in liver transplant recipients. Enterococcus spp (20%) occurred as urinary tract pathogens in kidney transplant recipients and as digestive tract pathogens in liver transplant recipients, and Pseudomonas aeruginosa (9%) in lung transplant recipients. Among 1039 viral infections, herpesviruses predominated (51%) in kidney, liver, and heart transplant recipients. Among 263 fungal infections, Candida spp (60%) prevailed as digestive tract pathogens in liver transplant recipients. Opportunistic pathogens, including Aspergillus fumigatus (1.4%) and cytomegalovirus (6%), were rare, scattering over 12 months across all SOT recipients. Conclusions In the current era of immunosuppression and prophylaxis, SOT recipients experience a high burden of infections throughout the first year posttransplantation, with rare opportunistic pathogens and a predominance of bacteria.

scholarly journals Peritoneal Dialysis After Liver Transplantation: A Systematic Review

2021 ◽  
Vol 8 ◽  
pp. 205435812110297
Author(s):  
Jean Maxime Côté ◽  
Isabelle Ethier ◽  
Héloïse Cardinal ◽  
Marie-Noëlle Pépin
Keyword(s):  
Systematic Review ◽  
Liver Transplantation ◽  
Liver Transplant ◽  
Kidney Failure ◽  
Liver Graft ◽  
Transplant Recipients ◽  
Technique Survival ◽  
Liver Transplant Recipients

Background: Chronic kidney disease following liver transplantation is a major long-term complication. Most liver transplant recipients with kidney failure will be treated with dialysis instead of kidney transplantation due to noneligibility and shortage in organ availability. In this population, the role of peritoneal dialysis (PD) as a modality of kidney replacement therapy (KRT) remains unclear. Objective: To determine the feasibility regarding safety, technique survival, and dialysis efficiency of PD in liver transplant recipients requiring KRT for maintenance dialysis. Design: Systematic review. Setting: Interventional and observational studies reporting the use of PD after liver transplantation. Patients: Adult liver transplant recipients with kidney failure treated with maintenance KRT. Measurements: Extracted data included eligibility criteria, study design, demographics, and PD modality. The following outcomes of interest were extracted: rate of peritonitis and microorganisms involved, noninfectious peritoneal complications, technique survival, and kidney transplantation-censored technique survival. Non-PD complications included overall survival, liver graft dysfunction, and hospitalization rate. Methods: The following databases were searched until July 2020: MedLine/PubMed, EMBASE, CINAHL, and Cochrane Library. Two reviewers independently screening all titles and abstracts of all identified articles. Due to the limited sample size, observational designs and study heterogeneity expected, no meta-analysis was pre-planned. Descriptive statistics were used to report all results. Results: From the 5263 identified studies, 4 were included in the analysis as they reported at least 1 outcome of interest on a total of 21 liver transplant recipients, with an overall follow-up duration on PD of 19.0 (Interquartile range [IQR]: 9.5-29.5) months. Fifteen episodes of peritonitis occurred in a total cumulative PD follow-up of 514 patient-months, representing an incidence rate of 0.35 per year. These episodes did not result in PD technique failure, mortality, or impairment of liver graft function. Limitations: Limitations include the paucity of studies in the field and the small number of patients included in each report, a risk of publication bias and the impossibility to directly compare hemodialysis to PD in this population. These results, therefore, must be interpreted with caution. Conclusions: Based on limited data reporting the feasibility of PD in liver transplant recipients with kidney failure, no signal was associated with an increased risk of infectious complications. Long-term studies evaluating this modality need to be performed. Registration (PROSPERO): CRD42020218374.

LONG TERM FOLLOW UP OF 22 OPERATIONAL TOLERANT LIVER TRANSPLANT RECIPIENTS.

2010 ◽  
Vol 90 ◽  
pp. 33
Author(s):  
P. tryphonopoulos ◽  
P. Ruiz ◽  
D. Weppler ◽  
D. Levi ◽  
S. Nishida ◽  
...  
Keyword(s):  
Liver Transplant ◽  
Transplant Recipients ◽  
Long Term Follow Up ◽  
Liver Transplant Recipients

Liver Transplant Recipients' First Year of Posttransplant Recovery: A Longitudinal Study

2005 ◽  
Vol 15 (4) ◽  
pp. 345-352 ◽  
Author(s):  
Jill B. Jones
Keyword(s):  
Longitudinal Study ◽  
Liver Transplant ◽  
Lived Experience ◽  
Healthcare Personnel ◽  
Spiritual Needs ◽  
First Year ◽  
Transplant Recipients ◽  
Home Economic ◽  
Personality Changes ◽  
Liver Transplant Recipients

A longitudinal study of 20 liver transplant recipients was conducted to investigate their posttransplant recovery experience. Data were collected using semistructured interviews at 6 weeks, 6 months, and 1 year after transplantation. Qualitative analysis of data revealed physical, psychological, social, economic, and spiritual dimensions of recovery. Findings reflect ongoing improvement of physical health and functionality for most recipients. Those with continuing health problems often suffered from preexisting health conditions. Psychological adjustment was uneven, with intermittent periods of fear, anxiety, and depression. Some recipients reported short-lived split identities and personality changes. Social support of family was critical in the hospital and at home. Economic issues became primary by the 1-year interview, with all recipients questioning whether they could afford ongoing healthcare and medicines. Spiritual needs were met in secular and nonsecular activities. Findings suggest that healthcare personnel should attend to the lived experience of liver transplant recipients.

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