Article

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.

0 Bookmarks
 · 
57 Views
  • [Show abstract] [Hide abstract]
    ABSTRACT: The incidence of hepatocellular carcinoma (HCC) is increasing worldwide, largely due to hepatitis B virus (HBV), hepatitis C virus and liver cirrhosis. Chronic HBV infection is estimated to cause 55%-60% of the cases of HCC worldwide and over 70% in Asian countries. Liver resection is currently the mainstay of treatment due to the low surgical mortality, a wider treatment indication, and simplicity of post-treatment follow-up. There is an ever-increasing demand on surgeons to perform curative liver resection in HCC, with the hope of avoiding tumor recurrences. Hepatitis B-related-HCC has distinct clinicopathological features, which should be considered when treating the disease. The author presents a review of the recently evolving strategies and emerging therapies to improve HCC postresectional outcomes and focus on perioperative measures to improve patient outcome, with particular reference to the current status of adjuvant therapies in HCC patients after liver resection.
    World journal of gastroenterology : WJG. 09/2014; 20(35):12473-12484.
  • Source
    Chinese Journal of Clinical Oncology 06/2013;
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Salvage living donor liver transplantation (LDLT) after major hepatectomy has been considered a challenging procedure due to operative complexity. We report a successful case of salvage dual graft LDLT after right hepatectomy. A 48-year-old male was transferred to Daegu Catholic University Medical Center because of duodenal variceal bleeding. He underwent right hepatectomy due to hepatocellular carcinoma four years prior. We performed LDLT with dual graft from his wife and sister. During operation, portal vein anastomosis of the right lobe graft was performed using an interposing cadaveric iliac vein graft and the right gastroepiploic artery was anastomosed to the hepatic artery of the left lobe graft. Adequate graft inflow was demonstrated by postoperative imaging studies. He has been doing well with normal graft function for 31 months. Salvage dual graft LDLT could be undertaken successfully in patients with prior major hepatectomy under accurate preoperative planning and proper surgical techniques.
    Annals of surgical treatment and research. 08/2014; 87(2):108-11.

Full-text

Download
0 Downloads

Similar Publications