Definition and Prospective Assessment of Functional Recovery After Liver Transplantation: A New Objective Consensus-Based Metric for Safe Discharge.
Journal
Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society
ISSN: 1527-6473
Titre abrégé: Liver Transpl
Pays: United States
ID NLM: 100909185
Informations de publication
Date de publication:
10 2020
10 2020
Historique:
received:
10
02
2020
revised:
31
05
2020
accepted:
06
06
2020
pubmed:
6
7
2020
medline:
19
3
2021
entrez:
5
7
2020
Statut:
ppublish
Résumé
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.
Types de publication
Journal Article
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
1241-1253Investigateurs
Julio Abba
(J)
Armando Abergel
(A)
Pietro Addeo
(P)
Marc Antoine Allard
(MA)
Giuliana Amaddeo
(G)
Teresa Antonini
(T)
Rodolphe Anty
(R)
Louise Barbier
(L)
Denis Bernard
(D)
Anne Bignon
(A)
Olivier Boillot
(O)
Charlotte Bouzbib
(C)
Pauline Carles
(P)
Jean-Paul Cervoni
(JP)
Manuela Cesaretti
(M)
Faiza Chermak
(F)
Laurence Chiche
(L)
Oriana Ciacio
(O)
Audrey Coilly
(A)
Pauline Devauchelle
(P)
Alexandre Doussot
(A)
Laure Elkrief
(L)
Domitille Erard-Poinsot
(D)
François Faitot
(F)
Stéphanie Faure
(S)
Claire Francoz
(C)
Emiliano Giostra
(E)
Nicolas Golse
(N)
Claire Goumard
(C)
Astrid Herrero
(A)
Marie Noelle Hilleret
(MN)
Jean-Baptiste Hiriart
(JB)
Pauline Houssel Debry
(PH)
Antonio Iannelli
(A)
Nassim Kamar
(N)
Meriem Khalfallah
(M)
Guillaume Lassailly
(G)
Alexis Laurent
(A)
Noemie Laverdure
(N)
Pascal Lebray
(P)
Gilles Lebuffe
(G)
Alessandra Mazzola
(A)
Magdalena Meszaros
(M)
Guillaume Millet
(G)
Anne Minello
(A)
Fabrice Muscari
(F)
Georges-Philippe Pageaux
(GP)
Domitille Poinsot
(D)
Sylvie Radenne
(S)
Michel Rayar
(M)
Helene Regnault
(H)
Olivier Roux
(O)
Marika Rudler
(M)
Eric Savier
(E)
Astrid Schielke
(A)
Daniele Sommacale
(D)
Olivier Soubrane
(O)
Bertrand Suc
(B)
Stéphanie Truant
(S)
Célia Turco
(C)
José Ursic-Bedoya
(J)
Claire Vanlemmens
(C)
Emmanuel Weiss
(E)
Marie-Lorraine Wohel-Jagle
(ML)
Stefan Hofmeyr
(S)
Commentaires et corrections
Type : CommentIn
Type : ErratumIn
Informations de copyright
Copyright © 2020 by the American Association for the Study of Liver Diseases.
Références
Dienstag JL , Cosimi AB . Liver transplantation-a vision realized. N Engl J Med 2012;367:1483-1485.
Montano-Loza AJ , Meza-Junco J , Prado CMM , Lieffers JR , Baracos VE , Bain VG , Sawyer MB . Muscle wasting is associated with mortality in patients with cirrhosis. Clin Gastroenterol Hepatol 2012;10:166-173.
Washburn WK , Meo NA , Halff GA , Roberts JP , Feng S . Factors influencing liver transplant length of stay at two large-volume transplant centers. Liver Transpl 2009;15:1570-1578.
Keegan MT , Kramer DJ . Perioperative care of the liver transplant patient. Crit Care Clin 2016;32:453-473.
Mourad MM , Liossis C , Gunson BK , Mergental H , Isaac J , Muiesan P , et al. Etiology and management of hepatic artery thrombosis after adult liver transplantation. Liver Transpl 2014;20:713-723.
Axelrod DA , Lentine KL , Xiao H , Dzebisashvilli N , Schnitzler M , Tuttle-Newhall JE , Segev DL . National assessment of early biliary complications following liver transplantation: incidence and outcomes. Liver Transpl 2014;20:446-456.
Abeles A , Kwasnicki RM , Darzi A . Enhanced recovery after surgery: current research insights and future direction. World J Gastrointest Surg 2017;9:37-45.
Maessen JMC , Dejong CHC , Kessels AGH , von Meyenfeldt MF ; for Enhanced Recovery After Surgery (ERAS) Group. Length of stay: an inappropriate readout of the success of enhanced recovery programs. World J Surg 2008;32:971-975.
van Dam RM , Wong-Lun-Hing EM , van Breukelen GJP , Stoot JHMB , van der Vorst JR , Bemelmans MHA , et al. Open versus laparoscopic left lateral hepatic sectionectomy within an enhanced recovery ERAS® programme (ORANGE II-trial): study protocol for a randomised controlled trial. Trials 2012;13:54.
Fiore JF, Jr. , Bialocerkowski A , Browning L , Faragher IG , Denehy L . Criteria to determine readiness for hospital discharge following colorectal surgery. Dis Colon Rectum 2012;55:416-423.
Jeong O , Ryu SY , Park YK . Postoperative functional recovery after gastrectomy in patients undergoing enhanced recovery after surgery: a prospective assessment using standard discharge criteria. Medicine (Baltimore) 2016;95:e3140.
Wong-Lun-Hing EM , van Dam RM , Heijnen LA , Busch ORC , Terkivatan T , van Hillegersberg R , et al. Is current perioperative practice in hepatic surgery based on enhanced recovery after surgery (ERAS) principles? World J Surg 2014;38:1127-1140.
Brustia R , Monsel A , Conti F , Savier E , Rousseau G , Perdigao F , et al. Enhanced recovery in liver transplantation: a feasibility study. World J Surg 2019;43:230-241.
Pomery A , Schofield P , Xhilaga M , Gough K . Pragmatic, consensus-based minimum standards and structured interview to guide the selection and development of cancer support group leaders: a protocol paper. BMJ Open 2017;7:e014408.
Blaschke S , O’Callaghan CC , Schofield P . Nature-based care opportunities and barriers in oncology contexts: a modified international e-Delphi survey. BMJ Open 2017;7:e017456.
Adebiyi BO , Mukumbang FC , Okop KJ , Beytell AM . A modified Delphi study towards developing a guideline to inform policy on fetal alcohol spectrum disorders in South Africa: a study protocol. BMJ Open 2018;8:e019907.
Fiore JF , Browning L , Bialocerkowski A , Gruen RL , Faragher IG , Denehy L . Hospital discharge criteria following colorectal surgery:a systematic review. Colorectal Dis 2012;14:270-281.
van Vliet DCR , van der Meij E , Bouwsma EVA , Vonk Noordegraaf A , van den Heuvel B , Meijerink WJHJ , et al. A modified Delphi method toward multidisciplinary consensus on functional convalescence recommendations after abdominal surgery. Surg Endosc 2016;30:5583-5595.
Liberati A , Altman DG , Tetzlaff J , Mulrow C , Gøtzsche PC , Ioannidis JPA , et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration. BMJ 2009;339:b2700.
Schmidt RC . Managing Delphi surveys using nonparametric statistical techniques. Decis Sci 1997;28:763-774.
Hsu CC . The Delphi Technique: Making Sense of Consensus - Practical Assessment, Research & Evaluation. 2007;12. https://scholarworks.umass.edu/cgi/viewcontent.cgi?article=1177&context=pare. Accessed April 27, 2019.
Rowe G , Wright G . The Delphi technique as a forecasting tool: issues and analysis. Int J Forecasting 1999;15:353-375. https://www.sciencedirect.com/science/article/pii/S0169207099000187.
Murphy MK , Black NA , Lamping DL , McKee CM , Sanderson CF , Askham J , Marteau T . Consensus development methods, and their use in clinical guideline development. Health Technol Assess 1998;2:1-88.
Donohoe H , Stellefson M , Tennant B . Advantages and limitations of the e-Delphi technique: implications for health education researchers. Am J Health Educ 2012;43:38-46.
von Elm E , Altman DG , Egger M , Pocock SJ , Gøtzsche PC , Vandenbroucke JP ; for STROBE Initiative. The strengthening the reporting of observational studies in epidemiology (STROBE) statement: guidelines for reporting observational studies. Lancet 2007;370:1453-1457.
Wong-Lun-Hing EM , van Dam RM , van Breukelen GJP , Tanis PJ , Ratti F , van Hillegersberg R , et al.; for ORANGE II Collaborative Group. Randomized clinical trial of open versus laparoscopic left lateral hepatic sectionectomy within an enhanced recovery after surgery programme (ORANGE II study). Br J Surg 2017;104:525-535.
Boulkedid R , Abdoul H , Loustau M , Sibony O , Alberti C . Using and reporting the Delphi method for selecting healthcare quality indicators: a systematic review. PLoS One 2011;6:e20476.
Jones C , Kelliher L , Dickinson M , Riga A , Worthington T , Scott MJ , et al. Randomized clinical trial on enhanced recovery versus standard care following open liver resection. Br J Surg 2013;100:1015-1024.
Dasari BVM , Rahman R , Khan S , Bennett D , Hodson J , Isaac J , et al. Safety and feasibility of an enhanced recovery pathway after a liver resection: prospective cohort study. HPB (Oxford) 2015;17:700-706.
Ratti F , Cipriani F , Reineke R , Catena M , Comotti L , Beretta L , Aldrighetti L . Impact of ERAS approach and minimally-invasive techniques on outcome of patients undergoing liver surgery for hepatocellular carcinoma. Dig Liver Dis 2016;48:1243-1248.
Liang X , Ying H , Wang H , Xu H , Yu H , Cai L , et al. Enhanced recovery program versus traditional care in laparoscopic hepatectomy. Medicine (Baltimore) 2016;95:e2835.
Fukazawa K , Pretto EA Jr, Nishida S , Reyes JD , Gologorsky E . Factors associated with mortality within 24 h of liver transplantation: an updated analysis of 65,308 adult liver transplant recipients between 2002 and 2013. J Clin Anesth 2018;44:35-40.
Moreno R , Berenguer M . Post-liver transplantation medical complications. Ann Hepatol 2006;5:77-85.
Choudhary NS , Saigal S , Bansal RK , Saraf N , Gautam D , Soin AS . Acute and chronic rejection after liver transplantation: what a clinician needs to know. J Clin Exp Hepatol 2017;7:358-366.
Zeidan JH , Levi DM , Pierce R , Russo MW . Strategies that reduce 90-day readmissions and inpatient costs after liver transplantation. Liver Transpl 2018;24:1561-1569.