scholarly journals Endoscopic treatment of anastomotic biliary stricture after adult deceased donor liver transplantation with multiple plastic stents versus self-expandable metal stents: a systematic review and meta-analysis

2017 ◽  
Vol 31 (2) ◽  
pp. 131-151 ◽  
Author(s):  
Filippo Landi ◽  
Nicola de'Angelis ◽  
Ailton Sepulveda ◽  
Aleix Martínez-Pérez ◽  
Iradj Sobhani ◽  
...  
Keyword(s):  
Systematic Review ◽  
Liver Transplantation ◽  
Endoscopic Treatment ◽  
Biliary Stricture ◽  
Meta Analysis ◽  
Deceased Donor ◽  
Plastic Stents ◽  
Metal Stents ◽  
Donor Liver ◽  
Donor Liver Transplantation

scholarly journals Increased Surgical Complications but Improved Overall Survival with Adult Living Donor Compared to Deceased Donor Liver Transplantation: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 2020 ◽  
pp. 1-19
Author(s):  
Wei Tang ◽  
Jian-Guo Qiu ◽  
Yang Cai ◽  
Luo Cheng ◽  
Cheng-You Du
Keyword(s):  
Systematic Review ◽  
Liver Transplantation ◽  
Overall Survival ◽  
Complication Rate ◽  
Living Donor ◽  
Meta Analysis ◽  
Deceased Donor ◽  
Donor Liver ◽  
Perioperative Mortality ◽  
Donor Liver Transplantation

Background. Living donor liver transplantation (LDLT) provides an alternative to deceased donor liver transplantation (DDLT) for patients with end-stage liver disease in the circumstance of scarcity of deceased grafts. However, the outcomes of LDLT remain controversial. Method. A systematic review and meta-analysis were performed to compare the outcomes of LDLT with DDLT. Twelve outcomes were assessed. Results. Thirty-nine studies involving 38563 patients were included. LDLT was comparable in red blood cell transfusion, perioperative mortality, length of hospital stay, retransplantation rate, hepatitis C virus recurrence rate, and hepatocellular carcinoma recurrence rate with DDLT. Cold ischemia time was shorter and duration of recipient operation was longer in LDLT. Postoperative intra-abdominal bleeding rate occurred less frequently in LDLT recipients (odds ratio OR=0.64, 95%confidence interval CI=0.46−0.88, P=0.006), but this did not decrease the perioperative mortality. LDLT was associated with significantly higher biliary (OR=2.23, 95%CI=1.59−3.13, P<0.00001) and vascular (OR=2.00, 95%CI=1.31−3.07, P=0.001) complication rates and better overall survival (OS) (1 year: OR=1.32, 95%CI=1.01−1.72, P=0.04; 3 years: OR=1.39, 95%CI=1.14−1.69, P=0.0010; and 5 years: OR=1.33, 95%CI=1.04−1.70, P=0.02). According to subgroup analysis, biliary complication rate and OS improved dramatically as experience increased, while vascular complication rate could not be improved because it was mainly caused by the difference of the donor type itself. Conclusions. LDLT remains a valuable option for patients in need of liver transplantation for it provides an excellent alternative to DDLT without compromising recipient outcomes. Further refinement in biliary and vascular reconstruction techniques and the accumulation of liver transplantation centers’ experience are the key factors in expanding the application of LDLT.

scholarly journals Living vs. deceased donor liver transplantation for hepatocellular carcinoma: a systematic review and meta-analysis

2012 ◽  
Vol 27 (1) ◽  
pp. 140-147 ◽  
Author(s):  
Robert C. Grant ◽  
Lakhbir Sandhu ◽  
Peter R. Dixon ◽  
Paul D. Greig ◽  
David R. Grant ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Systematic Review ◽  
Liver Transplantation ◽  
Meta Analysis ◽  
Deceased Donor ◽  
Donor Liver ◽  
Donor Liver Transplantation ◽  
Deceased Donor Liver Transplantation

scholarly journals ENDOSCOPIC TREATMENT OF POST-LIVER TRANSPLANTATION ANASTOMOTIC BILIARY STRICTURE: systematic review andmeta-analysis

2014 ◽  
Vol 51 (3) ◽  
pp. 240-249 ◽  
Author(s):  
Lucas Souto NACIF ◽  
Wanderley Marques BERNARDO ◽  
Luca BERNARDO ◽  
Wellington ANDRAUS ◽  
Lucas TORRES ◽  
...  
Keyword(s):  
Systematic Review ◽  
Liver Transplantation ◽  
Endoscopic Treatment ◽  
Clinical Success ◽  
Controlled Trial ◽  
Balloon Dilation ◽  
Plastic Stents ◽  
Metal Stents ◽  
Complication Rates ◽  
Biliary Strictures

Context Biliary strictures after liver transplantation are recognized as its Achilles’ heel. The strictures are classified in anastomotic and ischemic or non-anastomotic biliary strictures, and they figure among the most common complications after liver transplantation. There are some treatment options including balloon dilation, the placement of multiple plastic stents and the placement of self-expandable metal stents and all of them seem to have good results. Objectives The aim of this study was to systematically review the literature concerning the results of the endoscopic treatment of anastomotic biliary strictures after liver transplantation. Methods A systematic review of the literature was performed on the management of anastomotic biliary strictures post- orthotopic liver transplantation. The Medline-PubMed, EMBASE, Scielo-LILACS, and Cochrane Databases were electronically searched from January 1966 to April 2013. Results No well-designed randomized controlled trial was found. Most studies were retrospective or prospective comparisons in design. One study (86 patients) compared the endoscopic and the percutaneous accesses. The sustained clinical success rates were similar but the treatment duration was longer in the percutaneous group access. Two studies (56 patients) compared balloon dilation with balloon dilation and multiple plastic stents. There were no differences concerning sustained clinical success and complication rates. Conclusions Balloon dilation is as effective as balloon dilation plus multiple plastic stenting for the resolution of the anastomotic biliary strictures. Well-designed randomized trials are still needed to compare balloon dilation versus multiple plastic stenting versus metallic stenting.

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