6533b827fe1ef96bd1287130

RESEARCH PRODUCT

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

René AdamVincent KaramValérie CailliezPavel TrunečkaDidier SamuelGiuseppe TisonePetr NěmecOlivier SoubraneStefan SchneebergerBruno GridelliWolf O. BechsteinAndrea RisalitiPal-dag LineMarco VivarelliMassimo RossiJacques PirenneJurgen L. KlempnauerAleh RummoFabrizio Di BenedettoKrzysztof ZieniewiczRoberto TroisiAndreas PaulToomas ValiOtto KollmarKarim BoudjemaEmir HotiMichele ColledanJohan PratschkeHauke LangIrinel PopescuBo-goran EriczonKestutis StrupasPaolo De SimoneEberhard KochsBruno HeydJean GugenheimAntonio D. PinnaWilliam BennetMirjalal KazimiPhilippe BachellierStephen J. WigmoreAllan RasmussenPierre-alain ClavienErnest HidalgoJohn G. O'gradyFrausto ZamboniMurat KilicChristophe DuvouxJohn G. O’grady

subject

Graft RejectionMalemedicine.medical_specialtyTime FactorsDrug Compoundingmedicine.medical_treatmentCalcineurin InhibitorsMedizinMEDLINEchemical and pharmacologic phenomenaLiver Transplant030230 surgeryLiver transplantationRisk AssessmentTacrolimusall contributing centers (www.eltr.org) and the European Liver and Intestine Transplant Association (ELITA)03 medical and health sciences0302 clinical medicineRisk FactorsProlonged releaseInternal medicinemedicineHumansAged; Calcineurin Inhibitors; Delayed-Action Preparations; Drug Compounding; Europe; Female; Graft Rejection; Graft Survival; Humans; Immunosuppressive Agents; Male; Middle Aged; Registries; Retrospective Studies; Risk Assessment; Risk Factors; Tacrolimus; Time Factors; Treatment Outcome; Liver TransplantationRegistriesAgedRetrospective StudiesTransplantationbusiness.industryGraft SurvivalImmunosuppressionRetrospective cohort studyMiddle AgedTacrolimusSettore MED/18Liver Transplantation3. Good healthEuropeTreatment Outcomesurgical procedures operativeDelayed-Action PreparationsFemale030211 gastroenterology & hepatologyTransplant patientbusinessRisk assessmentImmunosuppressive Agents

description

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. ispartof: TRANSPLANTATION vol:103 issue:9 pages:1844-1862 ispartof: location:United States status: published

yearjournalcountryeditionlanguage
2019-09-01Transplantation
https://doi.org/10.1097/tp.0000000000002700