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

IF 3.6 2区 医学 Q2 IMMUNOLOGY Transplantation Reviews Pub Date : 2023-01-01 DOI:10.1016/j.trre.2023.100747
Ki-Hun Kim, Sang-Hoon Kim, Hwui-Dong Cho
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引用次数: 1

摘要

背景标准移植物与受体重量比≥0.8%在活体供肝移植(LDLT)中被广泛接受;然而,潜在的供体库扩展到采用GRWR<;0.8%。本研究旨在调查SFSG对LDLT后短期和长期结果的影响。方法检索1995年1月至2022年1月的电子数据库,比较SFSG患者(GRWR<0.8%,SFSG组)和足够体积移植物(GRWR≥0.8%,非SFSG组。主要结果是一年、三年和五年总生存率(OS)和移植物生存率(GS),而次要结果是术后并发症。结果纳入了24项研究,共7996名患者。就OS而言,SFSG组的三年OS较差(HR:1.48,95%CI[1.01,2.15],p=0.04),但两组在一年OS(HR:1.50,95%CI[0.98,2.29],p=0.06)和五年OS(HR:1.40,95%CI[0.95,2.08],p=0.02)方面无显著差异。在GS中,一年OS无显著差异(HR 1.31,95%CI[1.00,1.72],p=0.05),三年期(HR 1.33,95%CI[0.97,1.82],p=0.07)和五年期GS(HR 1.17,95%CI=0.95,1.44],p=0.013)。除血管并发症发生率高和体积小综合征外,SFSG组的术后并发症相似。结论利用GRWR<;0.8%的长期OS和GS是可以接受的,尽管有血管并发症和小尺寸综合征的风险。
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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.

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来源期刊
Transplantation Reviews
Transplantation Reviews IMMUNOLOGY-TRANSPLANTATION
CiteScore
7.50
自引率
2.50%
发文量
40
审稿时长
29 days
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.
期刊最新文献
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