Recipient outcomes of salvage liver transplantation versus primary liver transplantation: A systematic review and meta-analysis.

Department of Hepatobiliary and Pancreatic Surgery, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China; Key Laboratory of Combined Multi-organ Transplantation, Ministry of Public Health, Zhejiang Province, China; Key Laboratory of Organ Transplantation, Zhejiang Province, China.
Liver Transplantation (Impact Factor: 3.94). 07/2012; DOI: 10.1002/lt.23521
Source: PubMed

ABSTRACT BACKGROUND: Salvage liver transplantation (SLT; liver resection followed by liver transplantation) has been performed after primary liver resection for many years. However, the true outcomes and risks of SLT relative to primary liver transplantation (PLT) remain unclear. METHODS: We performed a systematic review and meta-analysis to evaluate the survival rate and incidence of postoperative complications of SLT recipients. Of the 2,799 references screened, seven eligible studies were identified. RESULTS: The meta-analysis results indicated no statistically significant difference in the overall survival rate between SLT and PLT, with the pooled relative risk being 0.99 (95% confidence interval (CI), 0.90 to 1.09, p = 0. 867) at 1 year, 0.97 (95% CI, 0.83 to 1.13, p = 0. 675) at 3 years and 0.96 (95% CI, 0.81 to 1.13, p = 0. 613) at 5 years. With respect to postoperative complications, the incidence of sepsis and biliary complication showed no statistically significant difference between SLT and PLT, but there was a significantly higher incidence of bleeding with SLT (relative risk, 2.84; 95% CI, 1.57 to 5.13; p = 0. 001). CONCLUSION: SLT has similar overall survival to that of PLT. Given the limited organ donor pool, SLT might be an acceptable therapy for patients undergoing primary liver resection for HCC. Liver Transpl, 2012. © 2012 AASLD.

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