Right lobe split liver graft versus whole liver transplantation: A systematic review by updated traditional and cumulative meta-analysis.
Dig Liver Dis
; 50(12): 1274-1282, 2018 12.
Article
en En
| MEDLINE
| ID: mdl-30236766
ABSTRACT
INTRODUCTION:
Advancements in surgical techniques and experience of donor-recipient pairing has led to a wider use of right split liver grafts in adults. An update meta-analysis was conducted to compare right split liver graft (RSLG) and whole liver transplantation (WLT) using traditional and cumulative approaches.METHODS:
Databases were searched for relevant articles over the previous 20 years (MEDLINE, Embase, Cochrane Library, and Google Scholar). Meta-analyses were performed using both fixed and random effects models. Patient and graft survival were obtained using the inverse variance hazard ratio method.RESULTS:
Donors were significantly younger in the RSLG group than in the WLT group (MDâ¯=â¯-12.06 [-16.29 to -7.83]; Pâ¯<â¯.001). In addition, the model for end-stage liver disease (MELD) score was significantly lower in the RSLG group than in the WLT group (MDâ¯=â¯-2.45 [-4.61 to -.28]; Pâ¯=â¯.03). However, cold ischaemia time was significantly longer by 1â¯h in the RSLG group than in the WLT group (MDâ¯=â¯57 [20.63-92.73]; Pâ¯=â¯.002). Overall biliary, vascular, and outflow tract complications and hepatic artery thrombosis were significantly lower in the WLT group than in the RSLG group (odds ratio [OR]â¯=â¯1.75 [1.35-2.27], Pâ¯<â¯.001; ORâ¯=â¯1.91 [1.37-2.65], Pâ¯=â¯.006; Peto ORâ¯=â¯1.83 [1.19-2.82], Pâ¯=â¯.006; and Peto ORâ¯=â¯2.07 [1.39-3.10], Pâ¯=â¯.004, respectively). However, no difference in patient and graft survival was noted between the two cohorts.CONCLUSIONS:
Although the RSLG group had a higher postoperative complication rate than the WLT group, equal patient and graft survival benefits were observed.Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Trasplante de Hígado
/
Fallo Hepático
/
Hepatectomía
/
Hígado
Tipo de estudio:
Etiology_studies
/
Prognostic_studies
/
Systematic_reviews
Límite:
Humans
Idioma:
En
Revista:
Dig Liver Dis
Asunto de la revista:
GASTROENTEROLOGIA
Año:
2018
Tipo del documento:
Article