General compliance after liver transplantation for alcoholic cirrhosis

Berlakovich, G. A.; Langer, Felix B.; Freundorfer, Edith; Windhager, Thomas; Rockenschaub, Susanne; Sporn, Emanuel; Soliman, Thomas; Pokorny, H.; Steininger, R.; Mühlbacher, Ferdinand

doi:10.1007/s001470050298

Cited by 48 publications

(46 citation statements)

References 14 publications

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“…Rothenhäusler/Ehrentraut/Kapfhammer/ Lang/Zachoval/Bilzer/Schelling/Gerbes OLT recipients documented a figure of 16% at a mean follow-up time of 53.7 months [65]. Given that OLT recipients with immunosuppressive concentrations in blood not within the target range were enrolled in our study, it is possible that the prevalence of full PTSD in OLT recipients may be similar to that observed in the study by Stukas et al [53].…”

Section: Discussionmentioning

confidence: 55%

Psychiatric and Psychosocial Outcome of Orthotopic Liver Transplantation

Rothenhäusler¹,

Ehrentraut²,

Kapfhammer³

et al. 2002

Psychother Psychosom

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Background:The study aimed to explore the prevalence of psychiatric disorders among orthotopic liver transplantation (OLT) recipients, and to investigate how psychiatric morbidity was linked to health-related quality of life (HRQOL). Methods: We recruited 75 patients who had undergone OLT a median of 3.8 years previously (range = 5-129 months). Psychiatric morbidity was assessed using the Structural Clinical Interview for the DSM-III-R. Psychometric observer-rating and self-rating scales were administered to evaluate cognitive functioning (SKT), depressive symptomatology (HAMD 17 ), posttraumatic stress symptoms (PTSS-10), social support (SSS), and HRQOL (SF-36 Health Status Questionnaire). Treatment characteristics were obtained from medical records. Results: 22.7% (n = 17) of our sample had a current or probable psychiatric diagnosis according to DSM-III-R: 2.7% full posttraumatic stress disorder (PTSD) (n = 2), 2.7% major depressive disorder (MDD) comorbid to full PTSD (n = 2), 1.3% MDD comorbid to partial PTSD (n = 1), and 16% partial PTSD (n = 12). Patients with PTSD symptoms demonstrated lower cognitive performance, higher severity of depressive symptoms and more unfavorable perception of social support. OLT-related PTSD symptomatology was associated with maximal decrements in HRQOL. The duration of intensive care treatment, the number of medical complications, and the occurrence of acute rejection were positively correlated with the risk of PTSD symptoms subsequent to OLT. Conclusion: OLT-related PTSD symptomatology impairing HRQOL is a complication for a subgroup of OLT recipients. Health-care providers should be aware of the possible presence of PTSD in OLT survivors.

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Section: Discussionmentioning

confidence: 55%

Psychiatric and Psychosocial Outcome of Orthotopic Liver Transplantation

Rothenhäusler¹,

Ehrentraut²,

Kapfhammer³

et al. 2002

Psychother Psychosom

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“…Potential advantages of improved adherence and more consistent exposure with the extended release profile of tacrolimus QD (3)(4)(5)(6)(7) include a reduction in rejection and graft loss (8)(9)(10) on longer-term follow-up.…”

Section: Prograf (Astellas Pharma Europe Ltd Staines Uk; Hereafter mentioning

confidence: 99%

Once‐Daily Prolonged‐Release Tacrolimus (ADVAGRAF) Versus Twice‐Daily Tacrolimus (PROGRAF) in Liver Transplantation

Trunečka

Boillot

Seehofer³

et al. 2010

American Journal of Transplantation

113

105

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The efficacy and safety of dual-therapy regimens of twice-daily tacrolimus (BID; Prograf) and once-daily tacrolimus (QD; Advagraf) administered with steroids, without antibody induction, were compared in a multicenter, 1:1-randomized, two-arm, parallel-group study in 475 primary liver transplant recipients. A doubleblind, double-dummy 24-week period was followed by an open extension to 12 months posttransplant. The primary endpoint, event rate of biopsy-proven acute rejection (BPAR) at 24 weeks, was 33.7% for tacrolimus BID versus 36.3% for tacrolimus QD (Per-protocol set; p = 0.512; treatment difference 2.6%, 95% confidence interval −7.3%, 12.4%), falling within the predefined 15% noninferiority margin. At 12 months, BPAR episodes requiring treatment were similar for tacrolimus BID and QD (28.1% and 24.7%). Twelvemonth patient and graft survival was 90.8% and 85.6% for tacrolimus BID and 89.2% and 85.3% for tacrolimus QD. Adverse event (AE) profiles were similar for both tacrolimus BID and QD with comparable incidences of AEs and serious AEs. Tacrolimus QD was well tolerated with similar efficacy and safety profiles to tacrolimus BID.

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“…Immunosuppressant medication noncompliance seems higher (Յ23%) than previously reported in alcoholics (16%). 21 However, the 6 programs reporting some form of patient noncompliance found that transplantation outcomes were not 22 Drug interactions are theoretically possible because tacrolimus and cyclosporine, the most common immunosuppressants used in liver transplantation, as well as methadone and Levomethadyl acetate hydrochloride, use the cytochrome P-450 system (CYP3A4). 23,24 No program reported drug interactions, and we found no reports of significant clinical interaction in MEDLINE.…”

Section: Commentmentioning

confidence: 99%