BETTER LIVING DONOR LIVER TRANSPLANTATION PATIENT SURVIVAL COMPARED TO DECEASED DONOR — A SYSTEMATIC REVIEW AND META-ANALYSIS
ABSTRACT Background Deceased donor liver transplantation (DDLT) is the first choice, but living donor transplantation (LDLT) is an alternative to be considered in special situations, such as lack of donated organs and emergencies. So far, there is no consensus on which transplantation method provid...
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| Format: | Article |
| Language: | English |
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Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologia (IBEPEGE)
2022-04-01
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| Series: | Arquivos de Gastroenterologia |
| Subjects: | |
| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0004-28032022000100129&tlng=en |
| _version_ | 1818271510249340928 |
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| author | Lourianne Nascimento CAVALCANTE Renato Macedo Teixeira de QUEIROZ Cláudio Luiz da S L PAZ André Castro LYRA |
| author_facet | Lourianne Nascimento CAVALCANTE Renato Macedo Teixeira de QUEIROZ Cláudio Luiz da S L PAZ André Castro LYRA |
| author_sort | Lourianne Nascimento CAVALCANTE |
| collection | DOAJ |
| description | ABSTRACT Background Deceased donor liver transplantation (DDLT) is the first choice, but living donor transplantation (LDLT) is an alternative to be considered in special situations, such as lack of donated organs and emergencies. So far, there is no consensus on which transplantation method provides better survival and fewer complications, which is still an open point for discussion. Methods This meta-analysis compared the 1, 3, and 5-year patient and graft survival rates of LDLT and DDLT. We included studies published from April-2009 to June-2021 and adopted the generic model of the inverse of variance for the random effect of hazard ratios. The adequacy of the studies was determined using the Newcastle-Ottawa Scale — NOS (WELLS). Results For patient survival analysis, we included a total of 32,258 subjects. We found a statistically significant better survival for the LDLT group at 1, 3 and 5 years, respectively: 1.35 HR (95%CI 1.10—1.66, P=0.005), 1.26 HR (95%CI 1.09—1.46, P=0.002) and 1.27 HR (95%CI 1.09—1.48, P=0.002). Our meta-analysis evaluated a total of 21,276 grafts. In the overall analysis, the 1-year survival was improved in favor of the LDLT group (1.36 HR, 95%CI 1.16—1.60, P<0.0001), while the 3-year survival (1.13 HR, 95%CI 0.96—1.33, P<0.13), and 5 (0.99 HR, 95%CI 0.74—1.33, P<0.96), did not differ significantly. Conclusion This metanalysis detected a statistically significant greater 1-, 3- and 5-years patient survival favoring LDLT compared to DDLT as well as a statistically significant difference better 1-year graft survival favoring the LDLT group. |
| first_indexed | 2024-12-12T21:27:19Z |
| format | Article |
| id | doaj.art-5a0de54635f048c5bac971168ecac5ad |
| institution | Directory Open Access Journal |
| issn | 1678-4219 |
| language | English |
| last_indexed | 2024-12-12T21:27:19Z |
| publishDate | 2022-04-01 |
| publisher | Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologia (IBEPEGE) |
| record_format | Article |
| series | Arquivos de Gastroenterologia |
| spelling | doaj.art-5a0de54635f048c5bac971168ecac5ad2022-12-22T00:11:25ZengInstituto Brasileiro de Estudos e Pesquisas de Gastroenterologia (IBEPEGE)Arquivos de Gastroenterologia1678-42192022-04-0159112913610.1590/s0004-2803.202200001-22BETTER LIVING DONOR LIVER TRANSPLANTATION PATIENT SURVIVAL COMPARED TO DECEASED DONOR — A SYSTEMATIC REVIEW AND META-ANALYSISLourianne Nascimento CAVALCANTEhttps://orcid.org/0000-0003-1110-0931Renato Macedo Teixeira de QUEIROZhttps://orcid.org/0000-0002-9811-1598Cláudio Luiz da S L PAZhttps://orcid.org/0000-0002-9766-7324André Castro LYRAhttps://orcid.org/0000-0001-9010-8645ABSTRACT Background Deceased donor liver transplantation (DDLT) is the first choice, but living donor transplantation (LDLT) is an alternative to be considered in special situations, such as lack of donated organs and emergencies. So far, there is no consensus on which transplantation method provides better survival and fewer complications, which is still an open point for discussion. Methods This meta-analysis compared the 1, 3, and 5-year patient and graft survival rates of LDLT and DDLT. We included studies published from April-2009 to June-2021 and adopted the generic model of the inverse of variance for the random effect of hazard ratios. The adequacy of the studies was determined using the Newcastle-Ottawa Scale — NOS (WELLS). Results For patient survival analysis, we included a total of 32,258 subjects. We found a statistically significant better survival for the LDLT group at 1, 3 and 5 years, respectively: 1.35 HR (95%CI 1.10—1.66, P=0.005), 1.26 HR (95%CI 1.09—1.46, P=0.002) and 1.27 HR (95%CI 1.09—1.48, P=0.002). Our meta-analysis evaluated a total of 21,276 grafts. In the overall analysis, the 1-year survival was improved in favor of the LDLT group (1.36 HR, 95%CI 1.16—1.60, P<0.0001), while the 3-year survival (1.13 HR, 95%CI 0.96—1.33, P<0.13), and 5 (0.99 HR, 95%CI 0.74—1.33, P<0.96), did not differ significantly. Conclusion This metanalysis detected a statistically significant greater 1-, 3- and 5-years patient survival favoring LDLT compared to DDLT as well as a statistically significant difference better 1-year graft survival favoring the LDLT group.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0004-28032022000100129&tlng=enLiver transplantationliving donor liver transplantationdeceased donor liver transplantation |
| spellingShingle | Lourianne Nascimento CAVALCANTE Renato Macedo Teixeira de QUEIROZ Cláudio Luiz da S L PAZ André Castro LYRA BETTER LIVING DONOR LIVER TRANSPLANTATION PATIENT SURVIVAL COMPARED TO DECEASED DONOR — A SYSTEMATIC REVIEW AND META-ANALYSIS Arquivos de Gastroenterologia Liver transplantation living donor liver transplantation deceased donor liver transplantation |
| title | BETTER LIVING DONOR LIVER TRANSPLANTATION PATIENT SURVIVAL COMPARED TO DECEASED DONOR — A SYSTEMATIC REVIEW AND META-ANALYSIS |
| title_full | BETTER LIVING DONOR LIVER TRANSPLANTATION PATIENT SURVIVAL COMPARED TO DECEASED DONOR — A SYSTEMATIC REVIEW AND META-ANALYSIS |
| title_fullStr | BETTER LIVING DONOR LIVER TRANSPLANTATION PATIENT SURVIVAL COMPARED TO DECEASED DONOR — A SYSTEMATIC REVIEW AND META-ANALYSIS |
| title_full_unstemmed | BETTER LIVING DONOR LIVER TRANSPLANTATION PATIENT SURVIVAL COMPARED TO DECEASED DONOR — A SYSTEMATIC REVIEW AND META-ANALYSIS |
| title_short | BETTER LIVING DONOR LIVER TRANSPLANTATION PATIENT SURVIVAL COMPARED TO DECEASED DONOR — A SYSTEMATIC REVIEW AND META-ANALYSIS |
| title_sort | better living donor liver transplantation patient survival compared to deceased donor a systematic review and meta analysis |
| topic | Liver transplantation living donor liver transplantation deceased donor liver transplantation |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0004-28032022000100129&tlng=en |
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