Outcomes of Technical Variant Liver Transplantation versus Whole Liver Transplantation for Pediatric Patients: A Meta-AnalysisReport as inadecuate




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Objective

To overcome the shortage of appropriate-sized whole liver grafts for children, technical variant liver transplantation has been practiced for decades. We perform a meta-analysis to compare the survival rates and incidence of surgical complications between pediatric whole liver transplantation and technical variant liver transplantation.

Methods

To identify relevant studies up to January 2014, we searched PubMed-Medline, Embase, and Cochrane library databases. The primary outcomes measured were patient and graft survival rates, and the secondary outcomes were the incidence of surgical complications. The outcomes were pooled using a fixed-effects model or random-effects model.

Results

The one-year, three-year, five-year patient survival rates and one-year, three-year graft survival rates were significantly higher in whole liver transplantation than technical variant liver transplantation OR = 1.62, 1.90, 1.65, 1.78, and 1.62, respectively, p<0.05. There was no significant difference in five-year graft survival rate between the two groups OR = 1.47, p = 0.10. The incidence of portal vein thrombosis and biliary complications were significantly lower in the whole liver transplantation group OR = 0.45 and 0.42, both p<0.05. The incidence of hepatic artery thrombosis was comparable between the two groups OR = 1.21, p = 0.61.

Conclusions

Pediatric whole liver transplantation is associated with better outcomes than technical variant liver transplantation. Continuing efforts should be made to minimize surgical complications to improve the outcomes of technical variant liver transplantation.



Author: Hui Ye , Qiang Zhao , Yufang Wang , Dongping Wang, Zhouying Zheng, Paul Michael Schroder, Yao Lu, Yuan Kong, Wenhua Liang, Yushu

Source: http://plos.srce.hr/



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