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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 World+J+Gastroenterol
2017 ; 23
(20
): 3730-3743
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Different techniques for harvesting grafts for living donor liver
transplantation: A systematic review and meta-analysis
#MMPMID28611526
Li H
; Zhang JB
; Chen XL
; Fan L
; Wang L
; Li SH
; Zheng QL
; Wang XM
; Yang Y
; Chen GH
; Wang GS
World J Gastroenterol
2017[May]; 23
(20
): 3730-3743
PMID28611526
show ga
AIM: To perform a systematic review and meta-analysis on minimally vs
conventional invasive techniques for harvesting grafts for living donor liver
transplantation. METHODS: PubMed, Web of Science, EMBASE, and the Cochrane
Library were searched comprehensively for studies comparing MILDH with
conventional living donor hepatectomy (CLDH). Intraoperative and postoperative
outcomes (operative time, estimated blood loss, postoperative liver function,
length of hospital stay, analgesia use, complications, and survival rate) were
analyzed in donors and recipients. Articles were included if they: (1) compared
the outcomes of MILDH and CLDH; and (2) reported at least some of the above
outcomes. RESULTS: Of 937 articles identified, 13, containing 1592 patients, met
our inclusion criteria and were included in the meta-analysis. For donors,
operative time [weighted mean difference (WMD) = 20.68, 95%CI: -6.25-47.60, P =
0.13] and blood loss (WMD = -32.61, 95%CI: -80.44-5.21, P = 0.18) were comparable
in the two groups. In contrast, analgesia use (WMD = -7.79, 95%CI: -14.06-1.87, P
= 0.01), postoperative complications [odds ratio (OR) = 0.62, 95%CI: 0.44-0.89, P
= 0.009], and length of hospital stay (WMD): -1.25, 95%CI: -2.35-0.14, P = 0.03)
significantly favored MILDH. No differences were observed in recipient outcomes,
including postoperative complications (OR = 0.93, 95%CI: 0.66-1.31, P = 0.68) and
survival rate (HR = 0.96, 95%CI: 0.27-3.47, P = 0.95). Funnel plot and
statistical methods showed a low probability of publication bias. CONCLUSION:
MILDH is safe, effective, and feasible for living donor liver resection with
fewer donor postoperative complications, reduced length of hospital stay and
analgesia requirement than CLDH.