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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
Title | Impact of small-for-size liver grafts on medium-term and long-term graft survival in living donor liver transplantation: A meta-analysis |
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Authors | |
Keywords | Living donor liver transplantation Small-for-size grafts Small-for-size syndrome Graft survival |
Issue Date | 2019 |
Publisher | Baishideng 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? |
Abstract | BACKGROUND:
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 Identifier | http://hdl.handle.net/10722/285294 |
ISSN | 2023 Impact Factor: 4.3 2023 SCImago Journal Rankings: 1.063 |
PubMed Central ID | |
ISI Accession Number ID |
DC Field | Value | Language |
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dc.contributor.author | Ma, KW | - |
dc.contributor.author | Wong, KHC | - |
dc.contributor.author | Chan, ACY | - |
dc.contributor.author | Cheung, TT | - |
dc.contributor.author | Dai, WC | - |
dc.contributor.author | Fung, JYY | - |
dc.contributor.author | She, WH | - |
dc.contributor.author | Lo, CM | - |
dc.contributor.author | Chok, KSH | - |
dc.date.accessioned | 2020-08-18T03:52:07Z | - |
dc.date.available | 2020-08-18T03:52:07Z | - |
dc.date.issued | 2019 | - |
dc.identifier.citation | World Journal of Gastroenterology, 2019, v. 25 n. 36, p. 5559-5568 | - |
dc.identifier.issn | 1007-9327 | - |
dc.identifier.uri | http://hdl.handle.net/10722/285294 | - |
dc.description.abstract | BACKGROUND: 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.language | eng | - |
dc.publisher | Baishideng Publishing Group. The Journal's web site is located at http://www.wjgnet.com/1007-9327/index.htm | - |
dc.relation.ispartof | World Journal of Gastroenterology | - |
dc.rights | This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. | - |
dc.subject | Living donor liver transplantation | - |
dc.subject | Small-for-size grafts | - |
dc.subject | Small-for-size syndrome | - |
dc.subject | Graft survival | - |
dc.title | Impact of small-for-size liver grafts on medium-term and long-term graft survival in living donor liver transplantation: A meta-analysis | - |
dc.type | Article | - |
dc.identifier.email | Chan, ACY: acchan@hku.hk | - |
dc.identifier.email | Cheung, TT: cheung68@hku.hk | - |
dc.identifier.email | Dai, WC: daiwc@hku.hk | - |
dc.identifier.email | Fung, JYY: jfung@HKUCC-COM.hku.hk | - |
dc.identifier.email | She, WH: brianshe@hku.hk | - |
dc.identifier.email | Lo, CM: chungmlo@hkucc.hku.hk | - |
dc.identifier.email | Chok, KSH: chok6275@hku.hk | - |
dc.identifier.authority | Chan, ACY=rp00310 | - |
dc.identifier.authority | Cheung, TT=rp02129 | - |
dc.identifier.authority | Fung, JYY=rp00518 | - |
dc.identifier.authority | Lo, CM=rp00412 | - |
dc.identifier.authority | Chok, KSH=rp02110 | - |
dc.description.nature | published_or_final_version | - |
dc.identifier.doi | 10.3748/wjg.v25.i36.5559 | - |
dc.identifier.pmid | 31576100 | - |
dc.identifier.pmcid | PMC6767984 | - |
dc.identifier.scopus | eid_2-s2.0-85072759098 | - |
dc.identifier.hkuros | 312935 | - |
dc.identifier.volume | 25 | - |
dc.identifier.issue | 36 | - |
dc.identifier.spage | 5559 | - |
dc.identifier.epage | 5568 | - |
dc.identifier.isi | WOS:000488206500012 | - |
dc.publisher.place | United States | - |
dc.identifier.issnl | 1007-9327 | - |