Outcome of split liver transplantation vs living donor liver transplantation: A systematic review and meta-analysis.


Garzali I. U., Akbulut A. S., A. A., Naffa M., Aksoy F.

WORLD JOURNAL OF GASTROINTESTINAL SURGERY, cilt.15, sa.7, ss.1522-1531, 2023 (SCI-Expanded) identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 15 Sayı: 7
  • Basım Tarihi: 2023
  • Doi Numarası: 10.4240/wjgs.v15.i7.1522
  • Dergi Adı: WORLD JOURNAL OF GASTROINTESTINAL SURGERY
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED)
  • Sayfa Sayıları: ss.1522-1531
  • İnönü Üniversitesi Adresli: Evet

Özet

Background: The outcomes of liver transplantation (LT) from different grafts have been studied individually and in combination, but the reports were conflicting with some researchers finding no difference in both short-term and long-term outcomes between the deceased donor split LT (DD-SLT) and living donor LT (LDLT).

Aim: To compare the outcomes of DD-SLT and LDLT we performed this systematic review and meta-analysis.

Methods: This systematic review was performed in compliance with the Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines. The following databases were searched for articles comparing outcomes of DD-SLT and LDLT: PubMed; Google Scholar; Embase; Cochrane Central Register of Controlled Trials; the Cochrane Database of Systematic Reviews; and Reference Citation Analysis (https://www.referencecitationanalysis.com/). The search terms used were: "liver transplantation;" "liver transplant;" "split liver transplant;" "living donor liver transplant;" "partial liver transplant;" "partial liver graft;" "ex vivo splitting;" and "in vivo splitting."

Results: Ten studies were included for the data synthesis and meta-analysis. There were a total of 4836 patients. The overall survival rate at 1 year, 3 years and 5 years was superior in patients that received LDLT compared to DD-SLT. At 1 year, the hazard ratios was 1.44 (95% confidence interval: 1.16-1.78; P = 0.001). The graft survival rate at 3 years and 5 years was superior in the LDLT group (3 year hazard ratio: 1.28; 95% confidence interval: 1.01-1.63; P = 0.04).

Conclusion: This meta-analysis showed that LDLT has better graft survival and overall survival when compared to DD-SLT.