Titre :

Definition and prospective assessment of functional recovery after liver transplantation: a new objective, consensus-based metric for safe discharge

Auteur(s) :

Brustia, Raffaele [Auteur]
CHU Pitié-Salpêtrière [AP-HP]
Boleslawski, Emmanuel [Auteur]
Thérapies Lasers Assistées par l'Image pour l'Oncologie (ONCO-THAI) - U1189
Monsel, Antoine [Auteur]
Immunologie - Immunopathologie - Immunothérapie [CHU Pitié Salpêtrière] [I3]
CHU Pitié-Salpêtrière [AP-HP]
Université de Picardie Jules Verne [UPJV]
Barbier, Louise [Auteur]
Thérapies Assistées par Lasers et Immunothérapies pour l'Oncologie - U 1189 [OncoThAI]
Dharancy, Sebastien [Auteur]
Centre Hospitalier Régional Universitaire de Tours [CHRU Tours]
Adam, Rene [Auteur]
Service de Néphrologie et Transplantation rénale [CHRU-lille]
Dumortier, Jerome [Auteur]
Centre Hépato-Biliaire [Hôpital Paul Brousse] [CHB]
Lesurtel, Mickael [Auteur]
Hospices Civils de Lyon [HCL]
Conti, Filomena [Auteur]
Hospices Civils de Lyon [HCL]
Scatton, Olivier [Auteur]
CHU Pitié-Salpêtrière [AP-HP]

Titre de la revue :

Liver Transplantation

Nom court de la revue :

Liver Transpl.

Date de publication :

2020-07-04

ISSN :

1527-6473

Discipline(s) HAL :

Sciences du Vivant [q-bio]

Résumé en anglais : [en]

Standardized discharge criteria are critical to reduce premature discharge and avoid unnecessary hospital stays. No such criteria exist for patients undergoing liver transplantation (LT). To achieve a consensus-based ...
Lire la suite >Standardized discharge criteria are critical to reduce premature discharge and avoid unnecessary hospital stays. No such criteria exist for patients undergoing liver transplantation (LT). To achieve a consensus-based checklist of criteria for safe patient discharge after LT, this mixed-method study included the following: a systematic literature review and expert discussion to draft a first checklist of post-LT discharge criteria, defining patient recovery and indications for hospital discharge (functional recovery); an exploratory online electronic Delphi (e-Delphi) study; a single-center pilot study to test checklist feasibility; and a final e-Delphi study with an extended interdisciplinary expert panel to validate the final checklist. The first round provided a 10-point discharge checklist with 5 patient-centered items derived from discharge criteria after liver surgery and 5 graft-centered items derived from expert discussion. The restricted panel (9 experts) e-Delphi provided 100% consensus after the second round, with slight modifications to the criteria. During the pilot study, 19 of 45 (42.2%) patients included fulfilled the complete checklist (100% of 10 items) after median (IQR) 16 (8-21) days (functional recovery) and a length of stay of 20 (9-24) days. The item with the lowest completion rate was minimum serum tacrolimus level in the target on 2 consecutive blood samples (n = 21; 47%), achieved at 13 (9-15) days. The extended panel (66 experts) e-Delphi provided 95%-98% consensus after the third round, with slight modifications of the criteria. This study provided substantial consensus on discharge criteria after LT. We anticipate that these criteria will be useful in clinical practice to guide patient discharge and increase the comparability of results between future studies.Lire moins >

Langue :

Anglais

Audience :

Internationale

Vulgarisation :

Non

Établissement(s) :

CHU Lille
Inserm
Université de Lille

Collections :

• Institut de Recherche Translationnelle sur l'Inflammation (INFINITE) - U1286
• Thérapies Lasers Assistées par l'Image pour l'Oncologie (ONCO-THAI) - U1189

Date de dépôt :

2021-07-06T12:45:47Z
2024-02-05T13:35:56Z