Full-left-full-right split liver transplantation for adult recipients: a systematic review and meta-analysis
Author
Sneiders, Dimitrivan Dijk, Anne-Baue R M
Polak, Wojciech G
Mirza, Darius F
Perera, M Thamara P R
Hartog, Hermien
Publication date
2021-12-02Subject
Transplantation
Metadata
Show full item recordAbstract
Full-left-full-right split liver transplantation (FSLT) for adult recipients, may increase the availability of liver grafts, reduce waitlist time, and benefit recipients with below-average body weight. However, FSLT may lead to impaired graft and patient survival. This study aims to assess outcomes after FSLT. Five databases were searched to identify studies concerning FSLT. Incidences of complications, graft- and patient survival were assessed. Discrete data were pooled with random-effect models. Graft and patient survival after FSLT were compared with whole liver transplantation (WLT) according to the inverse variance method. Vascular complications were reported in 25/273 patients after FSLT (Pooled proportion: 6.9%, 95%CI: 3.1-10.7%, I2 : 36%). Biliary complications were reported in 84/308 patients after FSLT (Pooled proportion: 25.6%, 95%CI: 19-32%, I2 : 44%). Pooled proportions of graft and patient survival after 3 years follow-up were 72.8% (95%CI: 67.2-78.5, n = 231) and 77.3% (95%CI: 66.7-85.8, n = 331), respectively. Compared with WLT, FSLT was associated with increased graft loss (pooled HR: 2.12, 95%CI: 1.24-3.61, P = 0.006, n = 189) and patient mortality (pooled HR: 1.81, 95%CI: 1.17-2.81, P = 0.008, n = 289). FSLT was associated with high incidences of vascular and biliary complications. Nevertheless, long-term patient and graft survival appear acceptable and justify transplant benefit in selected patients.Citation
Sneiders D, van Dijk ARM, Polak WG, Mirza DF, Perera MTPR, Hartog H. Full-left-full-right split liver transplantation for adult recipients: a systematic review and meta-analysis. Transpl Int. 2021 Dec;34(12):2534-2546. doi: 10.1111/tri.14160. Epub 2021 Dec 2Type
ArticlePMID
34773303Journal
Transplant InternationalPublisher
Frontiers Mediaae974a485f413a2113503eed53cd6c53
10.1111/tri.14160