Right lobe split liver graft versus whole liver transplantation: A systematic review by updated traditional and cumulative meta-analysis.

Gavriilidis, Paschalis and Roberts, Keith J and Azoulay, Daniel (2018) Right lobe split liver graft versus whole liver transplantation: A systematic review by updated traditional and cumulative meta-analysis. Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver, 50 (12). pp. 1274-1282. ISSN 1878-3562. This article is available to all UHB staff and students via ASK Discovery tool http://tinyurl.com/z795c8c by using their UHB Athens login IDs

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Official URL: https://www.dldjournalonline.com/article/S1590-865...

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 (MD = -12.06 [-16.29 to -7.83]; P < .001). In addition, the model for end-stage liver disease (MELD) score was significantly lower in the RSLG group than in the WLT group (MD = -2.45 [-4.61 to -.28]; P = .03). However, cold ischaemia time was significantly longer by 1 h in the RSLG group than in the WLT group (MD = 57 [20.63-92.73]; P = .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] = 1.75 [1.35-2.27], P < .001; OR = 1.91 [1.37-2.65], P = .006; Peto OR = 1.83 [1.19-2.82], P = .006; and Peto OR = 2.07 [1.39-3.10], P = .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.

Item Type: Article
Additional Information: This article is available to all UHB staff and students via ASK Discovery tool http://tinyurl.com/z795c8c by using their UHB Athens login IDs
Subjects: WI Digestive system. Gastroenterology
Divisions: Planned IP Care > Gastroentrology
Related URLs:
Depositing User: Mrs Semanti Chakraborty
Date Deposited: 21 Jun 2019 15:13
Last Modified: 21 Jun 2019 15:13
URI: http://www.repository.heartofengland.nhs.uk/id/eprint/2175

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