Objective:To compare the differences in postoperative survival and complications between extended right liver transplantation(ERLT)and whole liver transplantation(WLT).Methods:The Chinese and English databases were se...Objective:To compare the differences in postoperative survival and complications between extended right liver transplantation(ERLT)and whole liver transplantation(WLT).Methods:The Chinese and English databases were searched for clinical studies on comparing ERLT with WLT for end-stage liver disease from the date of database construction to April 15,2022.The searched literature was de-duplicated and selected according to the order of title,abstract and content,after which NOS quality evaluation was performed for literature that matched the study.Postoperative complications and survival data were extracted from the eligible literature and subjected to Meta-analysis with Review Manager 5.3,and finally data sensitivity analysis and publication bias tests were performed.Results:The complication of ERLT such as biliary complications[OR=1.77,95%CI=(1.39,2.25),P<0.00001],biliary leakage[OR=2.16,95%CI=(1.64,2.84),P<0.0001],total vascular complications[OR=2.00,95%CI=(1.48,2.70),P<0.0001],hepatic arterial thrombosis[OR=2.06,95%CI=(1.50,2.83),P<0.00001],re-Transplantation[OR=1.93,95%CI=(1.53,2.45),P<0.00001]have a higher occurrence rate compared with WLT.While the biliary stenosis[OR=0.74,95%CI=(0.48,1.15),P=0.18],hepatic portal vein thrombosis[OR=1.72,95%CI=(0.84,3.49),P=0.14],primary non-function[OR=1.27,95%CI=(0.80,2.02),P=0.32]had no statistically difference in the incidence of complications after liver transplantation.In terms of survival,ERLT had lower 1-year graft survival rate[OR=0.64,95%CI=(0.54,0.76),P<0.00001]and patient survival rate[OR=0.75,95%CI=(0.62,0.91),P=0.003]than WLT.Fortunately,there was no statistically difference in 5-year graft survival rate[OR=0.97,95%CI=(0.76,1.23),P=0.78]and 5-year patient survival rate[OR=0.94,95%CI=(0.78,1.14),P=0.54].Conclusion:ERLT is a safe and effective treatment for adult end-stage liver disease.As a surgical method with postoperative complications and survival similar to that of WLT,ERLT can increase the source of donor liver.展开更多
基金Key Science and Technology Project of Hainan Province(No.ZDK2019009)Construction of Clinical Medical Center of Hainan Province(Organ Transplantation)。
文摘Objective:To compare the differences in postoperative survival and complications between extended right liver transplantation(ERLT)and whole liver transplantation(WLT).Methods:The Chinese and English databases were searched for clinical studies on comparing ERLT with WLT for end-stage liver disease from the date of database construction to April 15,2022.The searched literature was de-duplicated and selected according to the order of title,abstract and content,after which NOS quality evaluation was performed for literature that matched the study.Postoperative complications and survival data were extracted from the eligible literature and subjected to Meta-analysis with Review Manager 5.3,and finally data sensitivity analysis and publication bias tests were performed.Results:The complication of ERLT such as biliary complications[OR=1.77,95%CI=(1.39,2.25),P<0.00001],biliary leakage[OR=2.16,95%CI=(1.64,2.84),P<0.0001],total vascular complications[OR=2.00,95%CI=(1.48,2.70),P<0.0001],hepatic arterial thrombosis[OR=2.06,95%CI=(1.50,2.83),P<0.00001],re-Transplantation[OR=1.93,95%CI=(1.53,2.45),P<0.00001]have a higher occurrence rate compared with WLT.While the biliary stenosis[OR=0.74,95%CI=(0.48,1.15),P=0.18],hepatic portal vein thrombosis[OR=1.72,95%CI=(0.84,3.49),P=0.14],primary non-function[OR=1.27,95%CI=(0.80,2.02),P=0.32]had no statistically difference in the incidence of complications after liver transplantation.In terms of survival,ERLT had lower 1-year graft survival rate[OR=0.64,95%CI=(0.54,0.76),P<0.00001]and patient survival rate[OR=0.75,95%CI=(0.62,0.91),P=0.003]than WLT.Fortunately,there was no statistically difference in 5-year graft survival rate[OR=0.97,95%CI=(0.76,1.23),P=0.78]and 5-year patient survival rate[OR=0.94,95%CI=(0.78,1.14),P=0.54].Conclusion:ERLT is a safe and effective treatment for adult end-stage liver disease.As a surgical method with postoperative complications and survival similar to that of WLT,ERLT can increase the source of donor liver.
