دورية أكاديمية
Comparing High- and Low-Model for End-Stage Liver Disease Living-Donor Liver Transplantation to Determine Clinical Efficacy: A Systematic Review and Meta-Analysis (CHALICE Study)
| العنوان: | Comparing High- and Low-Model for End-Stage Liver Disease Living-Donor Liver Transplantation to Determine Clinical Efficacy: A Systematic Review and Meta-Analysis (CHALICE Study) |
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| المؤلفون: | Jayant, Kumar, Cotter, Thomas G, Reccia, Isabella, Virdis, Francesco, Podda, Mauro, Machairas, Nikolaos, Arasaradnam, Ramesh P, Sabato, Diego di, LaMattina, John C, Barth, Rolf N, Witkowski, Piotr, Fung, John J |
| المساهمون: | Jayant, Kumar, Cotter, Thomas G, Reccia, Isabella, Virdis, Francesco, Podda, Mauro, Machairas, Nikolao, Arasaradnam, Ramesh P, Sabato, Diego di, Lamattina, John C, Barth, Rolf N, Witkowski, Piotr, Fung, John J |
| سنة النشر: | 2023 |
| المجموعة: | Università degli Studi di Cagliari: UNICA IRIS |
| مصطلحات موضوعية: | High MELD, Liver transplant, Living donor, Living donor liver transplant (LDLT) |
| الوصف: | Introduction: Various studies have demonstrated that low-Model for End-Stage Liver Disease (MELD) living-donor liver transplant (LDLT) recipients have better outcomes with improved patient survival than deceased-donor liver transplantation (DDLT) recipients. LDLT recipients gain the most from being transplanted at MELD <25-30; however, some existing data have outlined that LDLT may provide equivalent outcomes in high-MELD and low-MELD patients, although the term "high" MELD is arbitrarily defined in the literature and various cut-off scores are outlined between 20 and 30, although most commonly, the dividing threshold is 25. The aim of this meta-analysis was to compare LDLT in high-MELD with that in low-MELD recipients to determine patient survival and graft survival, as well as perioperative and postoperative complications. Methods: Following PROSPERO registration CRD-42021261501, a systematic database search was conducted for the published literature between 1990 and 2021 and yielded a total of 10 studies with 2183 LT recipients; 490 were HM-LDLT recipients and 1693 were LM-LDLT recipients. Results: Both groups had comparable mortality at 1, 3 and 5 years post-transplant (5-year HR 1.19; 95% CI 0.79-1.79; p-value 0.40) and graft survival (HR 1.08; 95% CI 0.72, 1.63; p-value 0.71). No differences were observed in the rates of major morbidity, hepatic artery thrombosis, biliary complications, intra-abdominal bleeding, wound infection and rejection; however, the HM-LDLT group had higher risk for pulmonary infection, abdominal fluid collection and prolonged ICU stay. Conclusions: The high-MELD LDLT group had similar patient and graft survival and morbidities to the low-MELD LDLT group, despite being at higher risk for pulmonary infection, abdominal fluid collection and prolonged ICU stay. The data, primarily sourced from high-volume Asian centers, underscore the feasibility of living donations for liver allografts in high-MELD patients. Given the rising demand for liver allografts, it is sensible to incorporate ... |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| العلاقة: | info:eu-repo/semantics/altIdentifier/pmid/37762738; info:eu-repo/semantics/altIdentifier/wos/WOS:001076611700001; volume:12; issue:18; numberofpages:19; journal:JOURNAL OF CLINICAL MEDICINE; https://hdl.handle.net/11584/386155Test; info:eu-repo/semantics/altIdentifier/scopus/2-s2.0-85172803823 |
| DOI: | 10.3390/jcm12185795 |
| الإتاحة: | https://doi.org/10.3390/jcm12185795Test https://hdl.handle.net/11584/386155Test |
| حقوق: | info:eu-repo/semantics/openAccess |
| رقم الانضمام: | edsbas.539BF3E8 |
| قاعدة البيانات: | BASE |
| DOI: | 10.3390/jcm12185795 |
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