Anne C van Erp1, Leon F A van Dullemen2, Rutger J Ploeg3, Henri G D Leuvenink4. 1. Department of Surgery, University Medical Centre Groningen, the Netherlands. Electronic address: a.c.van.erp@umcg.nl. 2. Department of Surgery, University Medical Centre Groningen, the Netherlands. Electronic address: leonvandullemen@gmail.com. 3. Nuffield Department of Surgical Sciences, University of Oxford, United Kingdom. Electronic address: rutger.ploeg@nds.ox.ac.uk. 4. Department of Surgery, University Medical Centre Groningen, the Netherlands. Electronic address: h.g.d.leuvenink@umcg.nl.
Abstract
BACKGROUND: Currently, there is no consensus on which treatments should be a part of standard deceased-donor management to improve graft quality and transplantation outcomes. The objective of this systematic review was to evaluate the effects of treatments of the deceased, solid-organ donor on graft function and survival after transplantation. METHODS: Pubmed, Embase, Cochrane, and Clinicaltrials.gov were systematically searched for randomized controlled trials that compared deceased-donor treatment versus placebo or no treatment. RESULTS: A total of 33 studies were selected for this systematic review. Eleven studies were included for meta-analyses on three different treatment strategies. The meta-analysis on methylprednisolone treatment in liver donors (two studies, 183 participants) showed no effect of the treatment on rates of acute rejection. The meta-analysis on antidiuretic hormone treatment in kidney donors (two studies, 222 participants) indicates no benefit in the prevention of delayed graft function. The remaining meta-analyses (seven studies, 334 participants) compared the effects of 10 min of ischaemic preconditioning on outcomes after liver transplantation and showed that ischaemic preconditioning improved short-term liver function, but not long-term transplant outcomes. CONCLUSIONS: There is currently insufficient evidence to conclude that any particular drug treatment or any intervention in the deceased donor improves long-term graft or patient survival after transplantation.
BACKGROUND: Currently, there is no consensus on which treatments should be a part of standard deceased-donor management to improve graft quality and transplantation outcomes. The objective of this systematic review was to evaluate the effects of treatments of the deceased, solid-organ donor on graft function and survival after transplantation. METHODS: Pubmed, Embase, Cochrane, and Clinicaltrials.gov were systematically searched for randomized controlled trials that compared deceased-donor treatment versus placebo or no treatment. RESULTS: A total of 33 studies were selected for this systematic review. Eleven studies were included for meta-analyses on three different treatment strategies. The meta-analysis on methylprednisolone treatment in liver donors (two studies, 183 participants) showed no effect of the treatment on rates of acute rejection. The meta-analysis on antidiuretic hormone treatment in kidney donors (two studies, 222 participants) indicates no benefit in the prevention of delayed graft function. The remaining meta-analyses (seven studies, 334 participants) compared the effects of 10 min of ischaemic preconditioning on outcomes after liver transplantation and showed that ischaemic preconditioning improved short-term liver function, but not long-term transplant outcomes. CONCLUSIONS: There is currently insufficient evidence to conclude that any particular drug treatment or any intervention in the deceased donor improves long-term graft or patient survival after transplantation.
Authors: Hong Pil Hwang; Jong Man Kim; Sung Shin; Hyung Joon Ahn; Sik Lee; Dong Jin Joo; Seung Yeup Han; Seok Jin Haam; Jeong Kye Hwang; Hee Chul Yu Journal: Korean J Transplant Date: 2020-09-30
Authors: Judith E van Zanden; Henri G D Leuvenink; Erik A M Verschuuren; Zwanida J Veldhuis; Petra J Ottens; Michiel E Erasmus; Maximilia C Hottenrott Journal: Transplant Direct Date: 2021-03-16
Authors: Judith E van Zanden; Neeltina M Jager; Mohamed R Daha; Michiel E Erasmus; Henri G D Leuvenink; Marc A Seelen Journal: Front Immunol Date: 2019-02-27 Impact factor: 7.561