Hypothermic oxygenated perfusion in liver transplantation: a meta-analysis of randomized controlled trials and matched studies

作者全名："Tang, Gang; Zhang, Linyu; Xia, Lingying; Zhang, Jie; Wei, Zhengqiang; Zhou, Rongxing"

作者地址："[Tang, Gang; Xia, Lingying; Zhang, Jie; Zhou, Rongxing] Sichuan Univ, West China Hosp, Biliary Surg Dept, Chengdu 610044, Sichuan, Peoples R China; [Zhang, Linyu] Sichuan Univ, West China Univ Hosp 2, Analyt & Testing Ctr, Chengdu, Sichuan, Peoples R China; [Xia, Lingying] Sichuan Univ, West China Univ Hosp 2, Ctr Translat Med, Chengdu, Sichuan, Peoples R China; [Tang, Gang; Wei, Zhengqiang] Chongqing Med Univ, Affiliated Hosp 1, Dept Gastrointestinal Surg, Chongqing, Peoples R China"

通信作者："Zhou, RX (通讯作者)，Sichuan Univ, West China Hosp, Biliary Surg Dept, Chengdu 610044, Sichuan, Peoples R China."

来源：INTERNATIONAL JOURNAL OF SURGERY

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001144567700008

JCR分区：Q1

影响因子：15.3

年份：2024

卷号：110

期号：1

开始页：464

结束页：477

文献类型：Article

关键词：graft preservation; hypothermic oxygenated machine perfusion; liver transplant; liver transplantation; meta-analysis

摘要："Background:Hypothermic oxygenated machine perfusion (HOPE) is a novel organ-preservation technology designed to optimize organ quality. However, the effects of HOPE on morbidity and mortality after liver transplantation remain unclear. This meta-analysis evaluated the potential benefits of HOPE in liver transplantation.Materials and methods:The Embase, Web of Science, PubMed, Cochrane Library, and Scopus databases were searched for articles published up to 15 June 2023 (updated on 12 August 2023). Mean differences (MDs), risk ratios (RRs), and 95% confidence intervals were calculated.Results:Eleven studies encompassing five randomized controlled trials and six matched studies were included, with a total of 1000 patients. HOPE did not reduce the incidence of major postoperative complications (RR 0.80), primary non-function (PNF) (RR 0.54), reperfusion syndrome (RR 0.92), hepatic artery thrombosis (RR 0.92), renal replacement therapy (RR 0.98), length of hospital stay (MD, -1.38 days), 1-year recipient death (RR 0.67), or intensive care unit stay (MD, 0.19 days) after liver transplantation. HOPE reduced the incidence of biliary complications (RR 0.74), non-anastomotic biliary strictures (NAS) (RR 0.34), early allograft dysfunction (EAD) (RR 0.54), and acute rejection (RR 0.54). In addition, HOPE improved the retransplantation (RR 0.42) and 1-year graft loss rates (RR 0.38).Conclusions:Compared with static cold storage (SCS), HOPE can reduce the incidence of biliary complications, NAS, EAD, and acute rejection and retransplantation rate after liver transplantation and improve the 1-year graft loss rate. These findings suggest that HOPE, when compared to SCS, can contribute to minimizing complications and enhancing graft survival in liver transplantation. Further research is needed to investigate long-term outcomes and confirm the promising advantages of HOPE in liver transplantation settings."

基金机构：National Natural ScienceFoundation of China [22004088]; Science & TechnologySupport Project of Sichuan Province [2023YFS0183]

基金资助正文：This work was financially supported by National Natural ScienceFoundation of China (22004088) and Science & TechnologySupport Project of Sichuan Province (2023YFS0183).