Hussaini Trana, Turgeon Ricky D, Partovi Nilufar, Erb Siegfried R, Scudamore Charles H, Yoshida Eric M
From the Faculty of Pharmaceutical Sciences, and Vancouver General Hospital, Vancouver, British Columbia, Canada.
Exp Clin Transplant. 2018 Oct;16(5):550-553. doi: 10.6002/ect.2017.0096. Epub 2017 Aug 28.
There is a clear lack of clinical evidence guiding immunosuppressive management in long-term stable liver transplant recipients. As a result, anecdotal experience suggests wide variability across transplant centers. We aimed to identify patterns of immunosuppression practices in liver transplant centers across Canada and the United States.
From February 9 to May 31, 2015, we invited clinicians from all liver transplant centers in Canada and the United States to answer a 6-question survey generated using SurveyMonkey.
Seventeen respondents from 15 liver transplant centers completed the survey. Although immun-suppressive practices are relatively uniform for induction and early maintenance therapy, significant variations exist in the management of long-term immunosuppression in stable transplant recipients with a relative lack of minimization protocols.
Our survey confirms a wide variability in immunosuppression practices across Canadian and US liver transplant centers. Research and practice priorities include design of pragmatic randomized controlled trials and development of clinical practice guidelines to standardize immunosuppressive management of long-term stable liver transplant recipients with a focus on immunosuppression minimization.
长期稳定的肝移植受者在免疫抑制管理方面明显缺乏临床证据指导。因此，坊间经验表明各移植中心的做法差异很大。我们旨在确定加拿大和美国各肝移植中心的免疫抑制实践模式。
2015年2月9日至5月31日，我们邀请了加拿大和美国所有肝移植中心的临床医生回答一份使用SurveyMonkey生成的包含6个问题的调查问卷。
来自15个肝移植中心的17名受访者完成了调查。尽管诱导和早期维持治疗的免疫抑制做法相对统一，但在稳定移植受者的长期免疫抑制管理方面存在显著差异，且相对缺乏最小化方案。
我们的调查证实了加拿大和美国肝移植中心在免疫抑制实践方面存在很大差异。研究和实践重点包括设计实用的随机对照试验以及制定临床实践指南，以规范长期稳定肝移植受者的免疫抑制管理，重点是免疫抑制最小化。
