Use of statins after liver transplantation is associated with improved survival : results of a nationwide study
© 2022 The Authors. Alimentary Pharmacology & Therapeutics published by John Wiley & Sons Ltd..
BACKGROUND: There is limited information on the effects of statins on the outcomes of liver transplantation (LT), regarding either their use by LT recipients or donors.
AIM: To analyse the association between statin exposure and recipient and graft survival.
METHODS: We included adult LT recipients with deceased donors in a nationwide prospective database study. Using a multistate modelling approach, we examined the effect of statins on the transition hazard between LT, biliary and vascular complications and death, allowing for recurring events. The observation time was 3 years.
RESULTS: We included 998 (696 male, 70%, mean age 54.46 ± 11.14 years) LT recipients. 14% of donors and 19% of recipients were exposed to statins during the study period. During follow-up, 141 patients died; there were 40 re-LT and 363 complications, with 66 patients having two or more complications. Treatment with statins in the recipient was modelled as a concurrent covariate and associated with lower mortality after LT (HR = 0.35; 95% CI 0.12-0.98; p = 0.047), as well as a significant reduction of re-LT (p = 0.004). However, it was not associated with lower incidence of complications (HR = 1.25; 95% CI = 0.85-1.83; p = 0.266). Moreover, in patients developing complications, statin use was significantly associated with decreased mortality (HR = 0.10; 95% CI = 0.01-0.81; p = 0.030), and reduced recurrence of complications (HR = 0.43; 95% CI = 0.20-0.93; p = 0.032).
CONCLUSIONS: Statin use by LT recipients may confer a survival advantage. Statin administration should be encouraged in LT recipients when clinically indicated.
| Errataetall: |
CommentIn: Aliment Pharmacol Ther. 2022 Nov;56(10):1509-1510. - PMID 36271472 |
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| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2022 |
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| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:56 |
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| Enthalten in: |
Alimentary pharmacology & therapeutics - 56(2022), 7 vom: 31. Okt., Seite 1194-1204 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Becchetti, Chiara [VerfasserIn] |
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| Links: |
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| Themen: |
Cardiovascular disease |
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| Anmerkungen: |
Date Completed 09.09.2022 Date Revised 12.02.2023 published: Print-Electronic CommentIn: Aliment Pharmacol Ther. 2022 Nov;56(10):1509-1510. - PMID 36271472 Citation Status MEDLINE |
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| doi: |
10.1111/apt.17192 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| 245 | 1 | 0 | |a Use of statins after liver transplantation is associated with improved survival |b results of a nationwide study |
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| 500 | |a CommentIn: Aliment Pharmacol Ther. 2022 Nov;56(10):1509-1510. - PMID 36271472 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2022 The Authors. Alimentary Pharmacology & Therapeutics published by John Wiley & Sons Ltd. | ||
| 520 | |a BACKGROUND: There is limited information on the effects of statins on the outcomes of liver transplantation (LT), regarding either their use by LT recipients or donors | ||
| 520 | |a AIM: To analyse the association between statin exposure and recipient and graft survival | ||
| 520 | |a METHODS: We included adult LT recipients with deceased donors in a nationwide prospective database study. Using a multistate modelling approach, we examined the effect of statins on the transition hazard between LT, biliary and vascular complications and death, allowing for recurring events. The observation time was 3 years | ||
| 520 | |a RESULTS: We included 998 (696 male, 70%, mean age 54.46 ± 11.14 years) LT recipients. 14% of donors and 19% of recipients were exposed to statins during the study period. During follow-up, 141 patients died; there were 40 re-LT and 363 complications, with 66 patients having two or more complications. Treatment with statins in the recipient was modelled as a concurrent covariate and associated with lower mortality after LT (HR = 0.35; 95% CI 0.12-0.98; p = 0.047), as well as a significant reduction of re-LT (p = 0.004). However, it was not associated with lower incidence of complications (HR = 1.25; 95% CI = 0.85-1.83; p = 0.266). Moreover, in patients developing complications, statin use was significantly associated with decreased mortality (HR = 0.10; 95% CI = 0.01-0.81; p = 0.030), and reduced recurrence of complications (HR = 0.43; 95% CI = 0.20-0.93; p = 0.032) | ||
| 520 | |a CONCLUSIONS: Statin use by LT recipients may confer a survival advantage. Statin administration should be encouraged in LT recipients when clinically indicated | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a cardiovascular disease | |
| 650 | 4 | |a dyslipidemia | |
| 650 | 4 | |a solid organ transplantation | |
| 650 | 4 | |a survival | |
| 650 | 7 | |a Hydroxymethylglutaryl-CoA Reductase Inhibitors |2 NLM | |
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| 700 | 1 | |a Müllhaupt, Beat |e verfasserin |4 aut | |
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| 700 | 1 | |a Bosch, Jaume |e verfasserin |4 aut | |
| 700 | 0 | |a Swiss Transplant Cohort Study |e verfasserin |4 aut | |
| 700 | 1 | |a Amico, Patrizia |e investigator |4 oth | |
| 700 | 1 | |a Axel, Andres |e investigator |4 oth | |
| 700 | 1 | |a Aubert, John-David |e investigator |4 oth | |
| 700 | 1 | |a Banz, Vanessa |e investigator |4 oth | |
| 700 | 1 | |a Sonja, Beckmann |e investigator |4 oth | |
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| 700 | 1 | |a Binet, Isabelle |e investigator |4 oth | |
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| 700 | 1 | |a Bucher, Heiner |e investigator |4 oth | |
| 700 | 1 | |a Carrel, Thierry |e investigator |4 oth | |
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| 700 | 1 | |a Chalandon, Yves |e investigator |4 oth | |
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| 700 | 1 | |a De Rougemont, Olivier |e investigator |4 oth | |
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| 700 | 1 | |a Dreifuss, Joëlle Lynn |e investigator |4 oth | |
| 700 | 1 | |a Duchosal, Michel |e investigator |4 oth | |
| 700 | 1 | |a Fehr, Thomas |e investigator |4 oth | |
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| 700 | 1 | |a Franscini, Nicola |e investigator |4 oth | |
| 700 | 1 | |a Garzoni, Christian |e investigator |4 oth | |
| 700 | 1 | |a Soccal, Paola Gasche |e investigator |4 oth | |
| 700 | 1 | |a Gaudet, Christophe |e investigator |4 oth | |
| 700 | 1 | |a Golshayan, Déla |e investigator |4 oth | |
| 700 | 1 | |a Goossens, Nicolas |e investigator |4 oth | |
| 700 | 1 | |a Hadaya, Karine |e investigator |4 oth | |
| 700 | 1 | |a Halter, Jörg |e investigator |4 oth | |
| 700 | 1 | |a Heim, Dominik |e investigator |4 oth | |
| 700 | 1 | |a Hess, Christoph |e investigator |4 oth | |
| 700 | 1 | |a Hillinger, Sven |e investigator |4 oth | |
| 700 | 1 | |a Hirsch, Hans |e investigator |4 oth | |
| 700 | 1 | |a Hirt, Patricia |e investigator |4 oth | |
| 700 | 1 | |a Hofbauer, Günther |e investigator |4 oth | |
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| 700 | 1 | |a Immer, Franz |e investigator |4 oth | |
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| 700 | 1 | |a Laager, Mirjam |e investigator |4 oth | |
| 700 | 1 | |a Laesser, Bettina |e investigator |4 oth | |
| 700 | 1 | |a Lehmann, Roger |e investigator |4 oth | |
| 700 | 1 | |a Leichtle, Alexander |e investigator |4 oth | |
| 700 | 1 | |a Lovis, Christian |e investigator |4 oth | |
| 700 | 1 | |a Manuel, Oriol |e investigator |4 oth | |
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| 700 | 1 | |a Stampf, Susanne |e investigator |4 oth | |
| 700 | 1 | |a Steiger, Jürg |e investigator |4 oth | |
| 700 | 1 | |a Stirniman, Guido |e investigator |4 oth | |
| 700 | 1 | |a Stürzinger, Ueli |e investigator |4 oth | |
| 700 | 1 | |a Van Delden, Christian |e investigator |4 oth | |
| 700 | 1 | |a Venetz, Jean-Pierre |e investigator |4 oth | |
| 700 | 1 | |a Villard, Jean |e investigator |4 oth | |
| 700 | 1 | |a Vionnet, Julien |e investigator |4 oth | |
| 700 | 1 | |a Wick, Madeleine |e investigator |4 oth | |
| 700 | 1 | |a Wilhlem, Markus |e investigator |4 oth | |
| 700 | 1 | |a Yerly, Patrick |e investigator |4 oth | |
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