Longterm Survival and Cost-Effectiveness of Immunosuppression Withdrawal After Liver Transplantation.
Liver Transpl
; 24(9): 1199-1208, 2018 09.
Article
em En
| MEDLINE
| ID: mdl-30129171
ABSTRACT
Lifelong immunosuppression (IS) after liver transplantation is associated with severe adverse effects and increased recipients' morbidity and mortality. Clinical operational tolerance has been reported in up to 40% in very well-selected recipients. Longterm survival and cost savings within the Italian national health system in operational tolerant recipients is reported. Seventy-five liver recipients were enrolled for IS withdrawal at our institution during the period from April 1998 to December 2015. The study population comprised 32 (42.7%) tolerant patients; 41 (54.7%) nontolerant patients needing uptake of IS after clinical or biopsy-proven rejection; and 2 (2.7%) immediate nontolerant patients who developed early rejection after the first drug reduction. The primary endpoint of the study was to assess the longterm patients and graft outcome; the secondary endpoint was the assessment of cost savings in the context of IS withdrawal. The follow-up was 95.0 months (interquartile range, 22.5-108.5 months). IS withdrawal did not result in patient nor graft loss and resulted in a major cost savings reaching about 630,000. In conclusion, longterm IS withdrawal represents a remarkable cost savings in the health care of liver recipients without exposing them to graft loss.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Transplante de Fígado
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Custos de Medicamentos
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Rejeição de Enxerto
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Sobrevivência de Enxerto
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Imunossupressores
Tipo de estudo:
Etiology_studies
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Health_economic_evaluation
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Observational_studies
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Risk_factors_studies
Limite:
Adult
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Female
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Humans
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Male
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Middle aged
País/Região como assunto:
Europa
Idioma:
En
Ano de publicação:
2018
Tipo de documento:
Article