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Article: Impact of small-for-size liver grafts on medium-term and long-term graft survival in living donor liver transplantation: A meta-analysis

TitleImpact of small-for-size liver grafts on medium-term and long-term graft survival in living donor liver transplantation: A meta-analysis
Authors
KeywordsLiving donor liver transplantation
Small-for-size grafts
Small-for-size syndrome
Graft survival
Issue Date2019
PublisherBaishideng Publishing Group. The Journal's web site is located at http://www.wjgnet.com/1007-9327/index.htm
Citation
World Journal of Gastroenterology, 2019, v. 25 n. 36, p. 5559-5568 How to Cite?
AbstractBACKGROUND: Small-for-size grafts (SFSGs) in living donor liver transplantation (LDLT) could optimize donor postoperative outcomes and also expand the potential donor pool. Evidence on whether SFSGs would affect medium-term and long-term recipient graft survival is lacking. AIM: To evaluate the impact of small-for-size liver grafts on medium-term and long-term graft survival in adult to adult LDLT. METHODS: A systematic review and meta-analysis were performed by searching eligible studies published before January 24, 2019 on PubMed, EMBASE, and Web of Science databases. The primary outcomes were 3-year and 5-year graft survival. Incidence of small-for-size syndrome and short term mortality were also extracted. RESULTS: This meta-analysis is reported according to the guidelines of the PRISMA 2009 Statement. Seven retrospective observational studies with a total of 1821 LDLT recipients were included in the meta-analysis. SFSG is associated with significantly poorer medium-term graft survival. The pooled odds ratio for 3-year graft survival was 1.58 [95% confidence interval 1.10-2.29, P = 0.014]. On the other hand, pooled results of the studies showed that SFSG had no significant discriminatory effect on 5-year graft survival with an odds ratio of 1.31 (95% confidence interval 0.87-1.97, P = 0.199). Furthermore, incidence of small-for-size syndrome detected in recipients of SFSG ranged from 0-11.4% in the included studies. CONCLUSION: SFSG is associated with inferior medium-term but not long-term graft survival. Comparable long-term graft survival based on liver graft size shows that smaller grafts could be accepted for LDLT with appropriate flow modulatory measures. Close follow-up for graft function is warranted within 3 years after liver transplantation.
Persistent Identifierhttp://hdl.handle.net/10722/285294
ISSN
2019 Impact Factor: 3.665
2015 SCImago Journal Rankings: 1.076
PubMed Central ID

 

DC FieldValueLanguage
dc.contributor.authorMa, KW-
dc.contributor.authorWong, KHC-
dc.contributor.authorChan, ACY-
dc.contributor.authorCheung, TT-
dc.contributor.authorDai, WC-
dc.contributor.authorFung, JYY-
dc.contributor.authorShe, WH-
dc.contributor.authorLo, CM-
dc.contributor.authorChok, KSH-
dc.date.accessioned2020-08-18T03:52:07Z-
dc.date.available2020-08-18T03:52:07Z-
dc.date.issued2019-
dc.identifier.citationWorld Journal of Gastroenterology, 2019, v. 25 n. 36, p. 5559-5568-
dc.identifier.issn1007-9327-
dc.identifier.urihttp://hdl.handle.net/10722/285294-
dc.description.abstractBACKGROUND: Small-for-size grafts (SFSGs) in living donor liver transplantation (LDLT) could optimize donor postoperative outcomes and also expand the potential donor pool. Evidence on whether SFSGs would affect medium-term and long-term recipient graft survival is lacking. AIM: To evaluate the impact of small-for-size liver grafts on medium-term and long-term graft survival in adult to adult LDLT. METHODS: A systematic review and meta-analysis were performed by searching eligible studies published before January 24, 2019 on PubMed, EMBASE, and Web of Science databases. The primary outcomes were 3-year and 5-year graft survival. Incidence of small-for-size syndrome and short term mortality were also extracted. RESULTS: This meta-analysis is reported according to the guidelines of the PRISMA 2009 Statement. Seven retrospective observational studies with a total of 1821 LDLT recipients were included in the meta-analysis. SFSG is associated with significantly poorer medium-term graft survival. The pooled odds ratio for 3-year graft survival was 1.58 [95% confidence interval 1.10-2.29, P = 0.014]. On the other hand, pooled results of the studies showed that SFSG had no significant discriminatory effect on 5-year graft survival with an odds ratio of 1.31 (95% confidence interval 0.87-1.97, P = 0.199). Furthermore, incidence of small-for-size syndrome detected in recipients of SFSG ranged from 0-11.4% in the included studies. CONCLUSION: SFSG is associated with inferior medium-term but not long-term graft survival. Comparable long-term graft survival based on liver graft size shows that smaller grafts could be accepted for LDLT with appropriate flow modulatory measures. Close follow-up for graft function is warranted within 3 years after liver transplantation.-
dc.languageeng-
dc.publisherBaishideng Publishing Group. The Journal's web site is located at http://www.wjgnet.com/1007-9327/index.htm-
dc.relation.ispartofWorld Journal of Gastroenterology-
dc.rightsThis work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.-
dc.subjectLiving donor liver transplantation-
dc.subjectSmall-for-size grafts-
dc.subjectSmall-for-size syndrome-
dc.subjectGraft survival-
dc.titleImpact of small-for-size liver grafts on medium-term and long-term graft survival in living donor liver transplantation: A meta-analysis-
dc.typeArticle-
dc.identifier.emailChan, ACY: acchan@hku.hk-
dc.identifier.emailCheung, TT: cheung68@hku.hk-
dc.identifier.emailDai, WC: daiwc@hku.hk-
dc.identifier.emailFung, JYY: jfung@HKUCC-COM.hku.hk-
dc.identifier.emailShe, WH: brianshe@hku.hk-
dc.identifier.emailLo, CM: chungmlo@hkucc.hku.hk-
dc.identifier.emailChok, KSH: chok6275@hku.hk-
dc.identifier.authorityChan, ACY=rp00310-
dc.identifier.authorityCheung, TT=rp02129-
dc.identifier.authorityFung, JYY=rp00518-
dc.identifier.authorityLo, CM=rp00412-
dc.identifier.authorityChok, KSH=rp02110-
dc.description.naturepublished_or_final_version-
dc.identifier.doi10.3748/wjg.v25.i36.5559-
dc.identifier.pmid31576100-
dc.identifier.pmcidPMC6767984-
dc.identifier.scopuseid_2-s2.0-85072759098-
dc.identifier.hkuros312935-
dc.identifier.volume25-
dc.identifier.issue36-
dc.identifier.spage5559-
dc.identifier.epage5568-
dc.publisher.placeUnited States-

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