Intraoperative and postoperative impact of pretransplantation transjugular intrahepatic portosystemic shunts in orthotopic liver transplantations: A systematic review and meta-analysis.

Autor:	Hinojosa-Gonzalez DE; School of Medicine and Health Sciences, Monterrey Institue of Technology, Monterrey, Mexico., Tellez-Garcia E; School of Medicine and Health Sciences, Monterrey Institue of Technology, Monterrey, Mexico., Salgado-Garza G; School of Medicine and Health Sciences, Monterrey Institue of Technology, Monterrey, Mexico., Roblesgil-Medrano A; School of Medicine and Health Sciences, Monterrey Institue of Technology, Monterrey, Mexico., Bueno-Gutierrez LC; School of Medicine and Health Sciences, Monterrey Institue of Technology, Monterrey, Mexico., Villegas-De Leon SU; School of Medicine and Health Sciences, Monterrey Institue of Technology, Monterrey, Mexico., Espadas-Conde MA; School of Medicine and Health Sciences, Monterrey Institue of Technology, Monterrey, Mexico., Herrera-Carrillo FE; School of Medicine and Health Sciences, Monterrey Institue of Technology, Monterrey, Mexico., Flores-Villalba E; School of Medicine and Health Sciences, Monterrey Institue of Technology, Monterrey, Mexico.; Department of Advanced Manufacturing, School of Engineering and Sciences, Monterrey Institue of Technology, Monterrey, Mexico.
Jazyk:	angličtina
Zdroj:	Turkish journal of surgery [Turk J Surg] 2022 Jun 29; Vol. 38 (2), pp. 121-133. Date of Electronic Publication: 2022 Jun 29 (Print Publication: 2022).
DOI:	10.47717/turkjsurg.2022.5702
Abstrakt:	Objectives: Orthotopic liver transplantation (OLT) remains the definitive treatment for patients afflicted with end-stage liver disease (ESLD). Transjugular intrahepatic portosystemic shunts (TIPS) have been adapted as a bridge to transplantation, allowing partial normalization of portal pressure and associated symptom improvement. Conflicting evidence exists on TIPS' impact on operative procedures. This study aimed to analyze available evidence on patients who underwent OLT with prior TIPS compared to OLT alone with the intent to determine TIPS' impact on surgical outcomes. Material and Methods: Following PRISMA guidelines, a systematic review was conducted, identifying studies comparing TIPS + OLT versus OLT alone in patients with ESLD. Data were analyzed using Review Manager 5.3. Results: Thirteen studies were included. Operative time, packed red blood cells transfusions, intensive care unit admission, length of stay, dialysis, serum creatinine levels, ascites, vascular complications, bleeding revisions, reintervention, and other complications rates were similar between both groups. Fresh frozen plasma transfusion -2.88 units (-5.42, -0.35; p= 0.03), was lower in the TIPS + OLT group. Conclusion: Our study found TIPS can be safely employed without having detrimental impacts on OLT outcomes, furthermore, these findings also suggest TIPS does not increase bleeding or complications. Competing Interests: Conflict of Interest: The authors have no conflicts of interest to declare. (Copyright © 2022, Turkish Surgical Society.)
Databáze:	MEDLINE
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