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.

Improved Survival in Liver Transplant Patients Receiving Prolonged-release Tacrolimus-based Immunosuppression in the European Liver Transplant Registry (ELTR): An Extension Study / Adam, R.; Karam, V.; Cailliez, V.; Trunecka, P.; Samuel, D.; Tisone, G.; Nemec, P.; Soubrane, O.; Schneeberger, S.; Gridelli, B.; Bechstein, W. O.; Risaliti, A.; Line, P. -D.; Vivarelli, M.; Rossi, M.; Pirenne, J.; Klempnauer, J. L.; Rummo, A.; Di Benedetto, F.; Zieniewicz, K.; Troisi, R.; Paul, A.; Vali, T.; Kollmar, O.; Boudjema, K.; Hoti, E.; Colledan, M.; Pratschke, J.; Lang, H.; Popescu, I.; Ericzon, B. -G.; Strupas, K.; De Simone, P.; Kochs, E.; Heyd, B.; Gugenheim, J.; Pinna, A. D.; Bennet, W.; Kazimi, M.; Bachellier, P.; Wigmore, S. J.; Rasmussen, A.; Clavien, P. -A.; Hidalgo, E.; O'Grady, J. G.; Zamboni, F.; Kilic, M.; Duvoux, C.. - In: TRANSPLANTATION. - ISSN 1534-6080. - 103:9(2019), pp. 1844-1862. [10.1097/TP.0000000000002700]

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

Vivarelli M.;Di Benedetto F.;Pinna A. D.;
2019

Abstract

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.
2019
103
9
1844
1862
Improved Survival in Liver Transplant Patients Receiving Prolonged-release Tacrolimus-based Immunosuppression in the European Liver Transplant Registry (ELTR): An Extension Study / Adam, R.; Karam, V.; Cailliez, V.; Trunecka, P.; Samuel, D.; Tisone, G.; Nemec, P.; Soubrane, O.; Schneeberger, S.; Gridelli, B.; Bechstein, W. O.; Risaliti, A.; Line, P. -D.; Vivarelli, M.; Rossi, M.; Pirenne, J.; Klempnauer, J. L.; Rummo, A.; Di Benedetto, F.; Zieniewicz, K.; Troisi, R.; Paul, A.; Vali, T.; Kollmar, O.; Boudjema, K.; Hoti, E.; Colledan, M.; Pratschke, J.; Lang, H.; Popescu, I.; Ericzon, B. -G.; Strupas, K.; De Simone, P.; Kochs, E.; Heyd, B.; Gugenheim, J.; Pinna, A. D.; Bennet, W.; Kazimi, M.; Bachellier, P.; Wigmore, S. J.; Rasmussen, A.; Clavien, P. -A.; Hidalgo, E.; O'Grady, J. G.; Zamboni, F.; Kilic, M.; Duvoux, C.. - In: TRANSPLANTATION. - ISSN 1534-6080. - 103:9(2019), pp. 1844-1862. [10.1097/TP.0000000000002700]
Adam, R.; Karam, V.; Cailliez, V.; Trunecka, P.; Samuel, D.; Tisone, G.; Nemec, P.; Soubrane, O.; Schneeberger, S.; Gridelli, B.; Bechstein, W. O.; Risaliti, A.; Line, P. -D.; Vivarelli, M.; Rossi, M.; Pirenne, J.; Klempnauer, J. L.; Rummo, A.; Di Benedetto, F.; Zieniewicz, K.; Troisi, R.; Paul, A.; Vali, T.; Kollmar, O.; Boudjema, K.; Hoti, E.; Colledan, M.; Pratschke, J.; Lang, H.; Popescu, I.; Ericzon, B. -G.; Strupas, K.; De Simone, P.; Kochs, E.; Heyd, B.; Gugenheim, J.; Pinna, A. D.; Bennet, W.; Kazimi, M.; Bachellier, P.; Wigmore, S. J.; Rasmussen, A.; Clavien, P. -A.; Hidalgo, E.; O'Grady, J. G.; Zamboni, F.; Kilic, M.; Duvoux, C.
File in questo prodotto:
File Dimensione Formato  
Improved_Survival_in_Liver_Transplant_Patients.21.pdf

Accesso riservato

Tipologia: Versione pubblicata dall'editore
Dimensione 393.63 kB
Formato Adobe PDF
393.63 kB Adobe PDF   Visualizza/Apri   Richiedi una copia
Pubblicazioni consigliate

Licenza Creative Commons
I metadati presenti in IRIS UNIMORE sono rilasciati con licenza Creative Commons CC0 1.0 Universal, mentre i file delle pubblicazioni sono rilasciati con licenza Attribuzione 4.0 Internazionale (CC BY 4.0), salvo diversa indicazione.
In caso di violazione di copyright, contattare Supporto Iris

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11380/1223017
Citazioni
  • ???jsp.display-item.citation.pmc??? 3
  • Scopus 8
  • ???jsp.display-item.citation.isi??? 8
social impact