Factors affecting survival after liver retransplantation: a systematic review and meta-analysis.

Autor:	Brombosz EW; Department of Surgery, Houston Methodist Hospital, Houston, TX, United States., Moore LW; Department of Surgery, Houston Methodist Hospital, Houston, TX, United States.; Department of Surgery, Weill Cornell Medical College, New York, NY, United States., Mobley CM; Department of Surgery, Houston Methodist Hospital, Houston, TX, United States.; Department of Surgery, Weill Cornell Medical College, New York, NY, United States.; JC Walter Jr Transplant Center, Houston Methodist Hospital, Houston, TX, United States.; Sherrie and Alan Conover Center for Liver Disease and Transplantation, Houston Methodist Hospital, Houston, TX, United States., Kodali S; JC Walter Jr Transplant Center, Houston Methodist Hospital, Houston, TX, United States.; Sherrie and Alan Conover Center for Liver Disease and Transplantation, Houston Methodist Hospital, Houston, TX, United States.; Department of Medicine, Weill Cornell Medical College, New York, NY, United States., Saharia A; Department of Surgery, Houston Methodist Hospital, Houston, TX, United States.; Department of Surgery, Weill Cornell Medical College, New York, NY, United States.; JC Walter Jr Transplant Center, Houston Methodist Hospital, Houston, TX, United States.; Sherrie and Alan Conover Center for Liver Disease and Transplantation, Houston Methodist Hospital, Houston, TX, United States., Hobeika MJ; Department of Surgery, Houston Methodist Hospital, Houston, TX, United States.; Department of Surgery, Weill Cornell Medical College, New York, NY, United States.; JC Walter Jr Transplant Center, Houston Methodist Hospital, Houston, TX, United States., Connor AA; Department of Surgery, Houston Methodist Hospital, Houston, TX, United States.; Department of Surgery, Weill Cornell Medical College, New York, NY, United States.; JC Walter Jr Transplant Center, Houston Methodist Hospital, Houston, TX, United States.; Sherrie and Alan Conover Center for Liver Disease and Transplantation, Houston Methodist Hospital, Houston, TX, United States., Victor DW 3rd; JC Walter Jr Transplant Center, Houston Methodist Hospital, Houston, TX, United States.; Sherrie and Alan Conover Center for Liver Disease and Transplantation, Houston Methodist Hospital, Houston, TX, United States.; Department of Medicine, Weill Cornell Medical College, New York, NY, United States., Cheah YL; Department of Surgery, Houston Methodist Hospital, Houston, TX, United States.; JC Walter Jr Transplant Center, Houston Methodist Hospital, Houston, TX, United States.; Sherrie and Alan Conover Center for Liver Disease and Transplantation, Houston Methodist Hospital, Houston, TX, United States., Simon CJ; Department of Surgery, Houston Methodist Hospital, Houston, TX, United States.; JC Walter Jr Transplant Center, Houston Methodist Hospital, Houston, TX, United States.; Sherrie and Alan Conover Center for Liver Disease and Transplantation, Houston Methodist Hospital, Houston, TX, United States., Gaber AO; Department of Surgery, Houston Methodist Hospital, Houston, TX, United States.; Department of Surgery, Weill Cornell Medical College, New York, NY, United States.; JC Walter Jr Transplant Center, Houston Methodist Hospital, Houston, TX, United States., Ghobrial RM; Department of Surgery, Houston Methodist Hospital, Houston, TX, United States.; Department of Surgery, Weill Cornell Medical College, New York, NY, United States.; JC Walter Jr Transplant Center, Houston Methodist Hospital, Houston, TX, United States.; Sherrie and Alan Conover Center for Liver Disease and Transplantation, Houston Methodist Hospital, Houston, TX, United States.
Jazyk:	angličtina
Zdroj:	Frontiers in transplantation [Front Transplant] 2023 May 31; Vol. 2, pp. 1181770. Date of Electronic Publication: 2023 May 31 (Print Publication: 2023).
DOI:	10.3389/frtra.2023.1181770
Abstrakt:	Background: Liver retransplantation (reLT) has historically had inferior survival relative to primary liver transplant (LT). To improve outcomes after reLT, researchers have identified factors predicting overall (OS) and/or graft survival (GS) after reLT. This systematic review and random effects meta-analysis sought to summarize this literature to elucidate the strongest independent predictors of post-reLT. Methods: A systematic review was conducted to identify manuscripts reporting factors affecting survival in multivariable Cox proportional hazards analyses. Papers with overlapping cohorts were excluded. Results: All 25 included studies were retrospective, and 15 (60%) were single-center studies. Patients on pre-transplant ventilation (HR, 3.11; 95% CI, 1.56-6.20; p  = 0.001) and with high serum creatinine (HR, 1.46; 95% CI, 1.15-1.87; p  = 0.002) had the highest mortality risk after reLT. Recipient age, Model for End-Stage Liver Disease score, donor age, and cold ischemia time >12 h also conferred a significant risk of post-reLT death (all p  < 0.05). Factors affecting GS included donor age and retransplant interval (the time between LT and reLT; both p  < 0.05). OS is significantly higher when the retransplant interval is ≤7 days relative to 8-30 days ( p  = 0.04). Conclusions: The meta-analysis was complicated by papers utilizing non-standardized cut-off values to group variables, which made between-study comparisons difficult. However, it did identify 7 variables that significantly impact survival after reLT, which could stimulate future research into improving post-reLT outcomes. Competing Interests: RMG is a member of the advisory board for TransMedics and has received stock in the company. The author RMG declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. (© 2023 Brombosz, Moore, Mobley, Kodali, Saharia, Hobeika, Connor, Victor, Cheah, Simon, Gaber and Ghobrial.)
Databáze:	MEDLINE
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