{"title":"使用小尺寸移植物的活体肝移植的短期和长期结果:系统回顾和荟萃分析","authors":"Ki-Hun Kim, Sang-Hoon Kim, Hwui-Dong Cho","doi":"10.1016/j.trre.2023.100747","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p>A standard graft-to-recipient weight ratio (GRWR) ≥0.8% is widely accepted in living-donor liver transplantation (LDLT); however, the potential donor pool is expanded to patients adopting small-for-size graft (SFSGs) with GRWR <0.8%. This study aimed to investigate the effect of SFSG on short- and long-term outcomes following LDLT.</p></div><div><h3>Methods</h3><p>Electronic databases were searched from January 1995 to January 2022 for studies comparing short- or long-term outcomes between patients with SFSG (GRWR <0.8%, SFSG group) and sufficient volume graft (GRWR ≥0.8%, non-SFSG group). The primary outcomes were one-, three-, and five-year overall survival (OS) and graft survival<span> (GS), while the secondary outcome was postoperative complications.</span></p></div><div><h3>Results</h3><p>Twenty-four studies comprising 7996 patients were included. In terms of OS, SFSG group had poor three-year OS (HR: 1.48, 95% CI [1.01, 2.15], <em>p</em> = 0.04), but there were no significant differences between two groups in one-year OS (HR: 1.50, 95% CI [0.98, 2.29], <em>p</em> = 0.06) and five-year OS (HR: 1.40, 95% CI [0.95, 2.08], <em>p</em> = 0.02). In GS, there were no significant differences in one-year (HR 1.31, 95% CI [1.00, 1.72], <em>p</em> = 0.05), three-year (HR 1.33, 95% CI [0.97, 1.82], <em>p</em> = 0.07), and five-year GS (HR 1.17, 95% CI [0.95, 1.44], <em>p</em> = 0.13). The SFSG group had comparable postoperative complications, except for a high incidence of vascular complications and small-for-size syndromes.</p></div><div><h3>Conclusions</h3><p>Expanding the potential donor pool in LDLT to SFSG with GRWR <0.8% can be acceptable in terms of comparable long-term OS and GS, despite the risk for vascular complications and small-for-size syndrome.</p></div>","PeriodicalId":48973,"journal":{"name":"Transplantation Reviews","volume":"37 1","pages":"Article 100747"},"PeriodicalIF":3.6000,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"1","resultStr":"{\"title\":\"The short- and long-term outcomes in living-donor liver transplantation using small-for-size graft: A systematic review and meta-analysis\",\"authors\":\"Ki-Hun Kim, Sang-Hoon Kim, Hwui-Dong Cho\",\"doi\":\"10.1016/j.trre.2023.100747\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><p>A standard graft-to-recipient weight ratio (GRWR) ≥0.8% is widely accepted in living-donor liver transplantation (LDLT); however, the potential donor pool is expanded to patients adopting small-for-size graft (SFSGs) with GRWR <0.8%. This study aimed to investigate the effect of SFSG on short- and long-term outcomes following LDLT.</p></div><div><h3>Methods</h3><p>Electronic databases were searched from January 1995 to January 2022 for studies comparing short- or long-term outcomes between patients with SFSG (GRWR <0.8%, SFSG group) and sufficient volume graft (GRWR ≥0.8%, non-SFSG group). The primary outcomes were one-, three-, and five-year overall survival (OS) and graft survival<span> (GS), while the secondary outcome was postoperative complications.</span></p></div><div><h3>Results</h3><p>Twenty-four studies comprising 7996 patients were included. In terms of OS, SFSG group had poor three-year OS (HR: 1.48, 95% CI [1.01, 2.15], <em>p</em> = 0.04), but there were no significant differences between two groups in one-year OS (HR: 1.50, 95% CI [0.98, 2.29], <em>p</em> = 0.06) and five-year OS (HR: 1.40, 95% CI [0.95, 2.08], <em>p</em> = 0.02). In GS, there were no significant differences in one-year (HR 1.31, 95% CI [1.00, 1.72], <em>p</em> = 0.05), three-year (HR 1.33, 95% CI [0.97, 1.82], <em>p</em> = 0.07), and five-year GS (HR 1.17, 95% CI [0.95, 1.44], <em>p</em> = 0.13). The SFSG group had comparable postoperative complications, except for a high incidence of vascular complications and small-for-size syndromes.</p></div><div><h3>Conclusions</h3><p>Expanding the potential donor pool in LDLT to SFSG with GRWR <0.8% can be acceptable in terms of comparable long-term OS and GS, despite the risk for vascular complications and small-for-size syndrome.</p></div>\",\"PeriodicalId\":48973,\"journal\":{\"name\":\"Transplantation Reviews\",\"volume\":\"37 1\",\"pages\":\"Article 100747\"},\"PeriodicalIF\":3.6000,\"publicationDate\":\"2023-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"1\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Transplantation Reviews\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0955470X23000010\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"IMMUNOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Transplantation Reviews","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0955470X23000010","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"IMMUNOLOGY","Score":null,"Total":0}
The short- and long-term outcomes in living-donor liver transplantation using small-for-size graft: A systematic review and meta-analysis
Background
A standard graft-to-recipient weight ratio (GRWR) ≥0.8% is widely accepted in living-donor liver transplantation (LDLT); however, the potential donor pool is expanded to patients adopting small-for-size graft (SFSGs) with GRWR <0.8%. This study aimed to investigate the effect of SFSG on short- and long-term outcomes following LDLT.
Methods
Electronic databases were searched from January 1995 to January 2022 for studies comparing short- or long-term outcomes between patients with SFSG (GRWR <0.8%, SFSG group) and sufficient volume graft (GRWR ≥0.8%, non-SFSG group). The primary outcomes were one-, three-, and five-year overall survival (OS) and graft survival (GS), while the secondary outcome was postoperative complications.
Results
Twenty-four studies comprising 7996 patients were included. In terms of OS, SFSG group had poor three-year OS (HR: 1.48, 95% CI [1.01, 2.15], p = 0.04), but there were no significant differences between two groups in one-year OS (HR: 1.50, 95% CI [0.98, 2.29], p = 0.06) and five-year OS (HR: 1.40, 95% CI [0.95, 2.08], p = 0.02). In GS, there were no significant differences in one-year (HR 1.31, 95% CI [1.00, 1.72], p = 0.05), three-year (HR 1.33, 95% CI [0.97, 1.82], p = 0.07), and five-year GS (HR 1.17, 95% CI [0.95, 1.44], p = 0.13). The SFSG group had comparable postoperative complications, except for a high incidence of vascular complications and small-for-size syndromes.
Conclusions
Expanding the potential donor pool in LDLT to SFSG with GRWR <0.8% can be acceptable in terms of comparable long-term OS and GS, despite the risk for vascular complications and small-for-size syndrome.
期刊介绍:
Transplantation Reviews contains state-of-the-art review articles on both clinical and experimental transplantation. The journal features invited articles by authorities in immunology, transplantation medicine and surgery.