Order of liver graft revascularization in deceased liver transplantation: A systematic review and meta-analysis
| Autor: | Kosei Takagi, Robert J. Porte, Piotr Domagala, Wojciech G. Polak |
|---|---|
| Přispěvatelé: | Surgery, Groningen Institute for Organ Transplantation (GIOT) |
| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
BLOOD medicine.medical_treatment Hemodynamics Neovascularization Physiologic ALLOGRAFT 030230 surgery Liver transplantation Revascularization PROFILE 03 medical and health sciences 0302 clinical medicine Postoperative Complications Liver Function Tests Risk Factors BILIARY STRICTURES medicine INJURY Humans PORTAL-VEIN REPERFUSION medicine.diagnostic_test business.industry Incidence (epidemiology) ARTERIALIZATION Graft Survival RETROGRADE REPERFUSION HEPATIC-ARTERY Confidence interval Tissue Donors Transplant Recipients Surgery Liver Transplantation Treatment Outcome 030220 oncology & carcinogenesis Relative risk Meta-analysis Surgical Procedures Operative business Liver function tests Biomarkers |
| Zdroj: | Surgery, 166(3), 237-246. Mosby Inc. Surgery, 166(3), 237-246. MOSBY-ELSEVIER |
| ISSN: | 0039-6060 |
| Popis: | Background: The ideal order for liver graft revascularization during liver transplantation remains unknown. The majority of liver transplant centers prefer portal venous reperfusion followed by arterial reperfusion to shorten the warm ischemia time. The aim of this study was to review the different revascularization techniques used in clinical liver transplantation to identify any potential clinical benefits.Methods: A systematic search of 5 databases was performed to identify all available original articles that reported liver transplantation and compared different techniques of reperfusion. The primary outcomes were patient and graft survival. Secondary outcomes were defined by postreperfusion syndrome, primary nonfunction, vascular complications, biliary complications, and retransplantation.Results: A total of 1,160 patients undergoing liver transplantation from 15 studies were included in this review and meta-analysis. There were no differences regarding the 1-year patient and graft survival for the revascularization techniques. The incidence of primary nonfunction, vascular complications, and retransplantation did not differ between the groups. Although there were no differences regarding biliary complications between the different groups, there were more nonanastomotic strictures in patients with initial portal revascularization (9%) compared with those with simultaneous revascularization (2%; risk ratio 1.07; 95% confidence interval, 1.00-1.14; P = .05; I-2= 51%).Conclusion: The order of liver graft revascularization does not influence patient and graft survival. Each revascularization technique offers potential benefits that can be used under specific clinical situations. (C) 2019 Elsevier Inc. All rights reserved. |
| Databáze: | OpenAIRE |
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