Profile of a Liver Transplant Follow‐Up Clinic in a Nontransplant Canadian Urban Centre

Abstract

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 immuno-suppressive 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.

Outcomes Following Liver Transplantation for Patients with Alcohol- Versus Nonalcohol-Induced Liver Disease

“…The results of the secondary outcome variables are given in Table 3. The following differences between alcoholic and nonalcoholic patients, respectively, were significant: acute rejection episodes (one in 10 , average creatinine concentration in the first six months after transplantation (156±51 µmol/L compared with 103±36 µmol/L, P<0.05), average total bilirubin concentration beyond six months after transplantation (15.5±5.1 µmol/L compared with 24.2±17.9 µmol/L, P<0.05) and average cyclosporine A level beyond six months after transplantation (256±67 µmol/L compared with 304±121 µmol/L, P<0.005). Two alcoholic patients (20%) separated from their spouses during the posttransplantation follow-up period compared with none of the 36 (0%) nonalcoholic patients who had spouses (P<0.05).…”

“…Formal alcohol counselling was not provided before or after the operation at any of these centres. The average duration of hospitalization for transplantation was approximately four weeks (10). Follow-up visits in the Liver Transplantation Follow-up Clinic were scheduled as follows: every week for one month, every two weeks for two months, every month for one year and every three months thereafter.…”