Compared efficacy of preservation solutions on the outcome of liver transplantation Meta-analysis /

AIM: To compare the effects of the four most commonly used preservation solutions on the outcome of liver transplantations. METHODS: A systematic literature search was performed using MEDLINE, Scopus, EMBASE and the Cochrane Library databases up to January 31(st), 2017. The inclusion criteria were c...

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Main Authors: Szilágyi Ágnes
Mátrai Péter
Hegyi Péter
Tuboly Eszter
Pécz Daniella
Garami András
Szekeres-Solymár Margit
Pétervári Erika
Balaskó Márta
Veres Gábor
Czopf László
Wobbe Bastian
Szabó Dorottya
Wagner Juliane
Hartmann Petra
Format: Article
Published: 2018
Series:WORLD JOURNAL OF GASTROENTEROLOGY 24 No. 16
doi:10.3748/wjg.v24.i16.1812

mtmt:3365841
Online Access:http://publicatio.bibl.u-szeged.hu/16034
Description
Summary:AIM: To compare the effects of the four most commonly used preservation solutions on the outcome of liver transplantations. METHODS: A systematic literature search was performed using MEDLINE, Scopus, EMBASE and the Cochrane Library databases up to January 31(st), 2017. The inclusion criteria were comparative, randomized controlled trials (RCTs) for deceased donor liver (DDL) allografts with adult and pediatric donors using the gold standard University of Wisconsin (UW) solution or histidine-tryptophan-ketoglutarate (HTK), Celsior (CS) and Institut Georges Lopez (IGL-1) solutions. Fifteen RCTs (1830 livers) were included; the primary outcomes were primary non-function (PNF) and one-year post-transplant graft survival (OGS-1). RESULTS: All trials were homogenous with respect to donor and recipient characteristics. There was no statistical difference in the incidence of PNF with the use of UW, HTK, CS and IGL-1 (RR = 0.02, 95%CI: 0.01-0.03, P = 0.356). Comparing OGS-1 also failed to reveal any difference between UW, HTK, CS and IGL-1 (RR = 0.80, 95%CI: 0.80-0.80, P = 0.369). Two trials demonstrated higher PNF levels for UW in comparison with the HTK group, and individual studies described higher rates of biliary complications where HTK and CS were used compared to the UW and IGL-1 solutions. However, the meta-analysis of the data did not prove a statistically significant difference: the UW, CS, HTK and IGL-1 solutions were associated with nearly equivalent outcomes. CONCLUSION: Alternative solutions for UW yield the same degree of safety and effectiveness for the preservation of DDLs, but further well-designed clinical trials are warranted.
Physical Description:1812-1824
ISSN:1007-9327