Jia-Zhong Wang1, Yang Liu1, Jin-Long Wang1, Le Lu1, Ya-Fei Zhang1, Hong-Wei Lu1, Yi-Ming Li1. 1. Jia-Zhong Wang, Yang Liu, Jin-Long Wang, Le Lu, Ya-Fei Zhang, Hong-Wei Lu, Yi-Ming Li, Department of General Surgery, Second Affiliated Hospital, Xi'an Jiaotong University School of Medicine, Xi'an 710004, Shaanxi Province, China.
Abstract
AIM: We undertook this meta-analysis to investigate the relationship between revascularization and outcomes after liver transplantation. METHODS: A literature search was performed using MeSH and key words. The quality of the included studies was assessed using the Jadad Score and the Newcastle-Ottawa Scale. Heterogeneity was evaluated by the χ(2) and I (2) tests. The risk of publication bias was assessed using a funnel plot and Egger's test, and the risk of bias was assessed using a domain-based assessment tool. A sensitivity analysis was conducted by reanalyzing the data using different statistical approaches. RESULTS: Six studies with a total of 467 patients were included. Ischemic-type biliary lesions were significantly reduced in the simultaneous revascularization group compared with the sequential revascularization group (OR = 4.97, 95%CI: 2.45-10.07; P < 0.00001), and intensive care unit (ICU) days were decreased (MD = 2.00, 95%CI: 0.55-3.45; P = 0.007) in the simultaneous revascularization group. Although warm ischemia time was prolonged in simultaneous revascularization group (MD = -25.84, 95%CI: -29.28-22.40; P < 0.00001), there were no significant differences in other outcomes between sequential and simultaneous revascularization groups. Assessment of the risk of bias showed that the methods of random sequence generation and blinding might have been a source of bias. The sensitivity analysis strengthened the reliability of the results of this meta-analysis. CONCLUSION: The results of this study indicate that simultaneous revascularization in liver transplantation may reduce the incidence of ischemic-type biliary lesions and length of stay of patients in the ICU.
AIM: We undertook this meta-analysis to investigate the relationship between revascularization and outcomes after liver transplantation. METHODS: A literature search was performed using MeSH and key words. The quality of the included studies was assessed using the Jadad Score and the Newcastle-Ottawa Scale. Heterogeneity was evaluated by the χ(2) and I (2) tests. The risk of publication bias was assessed using a funnel plot and Egger's test, and the risk of bias was assessed using a domain-based assessment tool. A sensitivity analysis was conducted by reanalyzing the data using different statistical approaches. RESULTS: Six studies with a total of 467 patients were included. Ischemic-type biliary lesions were significantly reduced in the simultaneous revascularization group compared with the sequential revascularization group (OR = 4.97, 95%CI: 2.45-10.07; P < 0.00001), and intensive care unit (ICU) days were decreased (MD = 2.00, 95%CI: 0.55-3.45; P = 0.007) in the simultaneous revascularization group. Although warm ischemia time was prolonged in simultaneous revascularization group (MD = -25.84, 95%CI: -29.28-22.40; P < 0.00001), there were no significant differences in other outcomes between sequential and simultaneous revascularization groups. Assessment of the risk of bias showed that the methods of random sequence generation and blinding might have been a source of bias. The sensitivity analysis strengthened the reliability of the results of this meta-analysis. CONCLUSION: The results of this study indicate that simultaneous revascularization in liver transplantation may reduce the incidence of ischemic-type biliary lesions and length of stay of patients in the ICU.
Authors: M Gastaca; A Matarranz; F Muñoz; A Valdivieso; A Aguinaga; M Testillano; J Bustamante; I Terreros; M J Suarez; M Montejo; J Ortiz de Urbina Journal: Transplant Proc Date: 2012 Jul-Aug Impact factor: 1.066
Authors: Jens G Brockmann; Christian August; Heiner H Wolters; Ralf Hömme; Daniel Palmes; Hideo Baba; Hans-U Spiegel; Karl H Dietl Journal: Liver Transpl Date: 2005-10 Impact factor: 5.799
Authors: T Reck; F Steinbauer; M Steinbauer; P O Schwille; C Wittekind; W Hohenberger; F Köckerling Journal: Transplantation Date: 1996-09-15 Impact factor: 4.939
Authors: Gero Puhl; Klaus-D Schaser; Daniel Pust; Katrin Köhler; Brigitte Vollmar; Michael D Menger; Peter Neuhaus; Utz Settmacher Journal: J Hepatol Date: 2004-08 Impact factor: 25.083