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Mela-analysis of the outcomes of liver transplantation from donation after cardiac death donors

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Author:
No author available
Journal Title:
Chinese Journal of Organ Transplantation
Issue:
12
DOI:
10.3760/cma.j.issn.0254-1785.2011.12.004
Key Word:
心脏死亡;脑死亡;组织供者;肝移植;Meta分析;Cardiac death;Brain death;Tissue donors;Liver transplantation;Meta-analysis

Abstract: Objective To conduct a meta-analysis to evaluate the outcomes of donation after cardiac death (DCD) compared with donation after brain death (DBD) liver transplantatior.Methods The MELDINE (1950-2011),EMBASE,and Cochrane Library databases were searched.All original single institution studies reporting outcomes of comparing donation after DCD and DBD liver transplantation were considered.A meta-analysis of complication incidence and patients/grafts survival after liver transplantation was conducted.Odds ratios (OR) and 95 % confidence intervals (CI) based on random effects models were calculated.Results Thirteen studies,all retrospective cohort studies,involving 5867 DCD and 619 DBD recipients,were included.DCD recipients had a 2.5 times increased odds of biliary complications (95 % CI =2.0~3.12),an 11.24 times increased odds of ischemic cholangiopathy (IC) (95 % CI =5.58 ~ 22.64 ),and a 2.12 times increased odds of primary nonfunction (PNF).DCD recipients also experienced lower odds of 1-year patient survival (OR =0.78,95 % CI=0.59~1.02),83.8 %,87.2 %,separately,and 1-year graft survival (OR=0.55,95% CI=0.45~0.68),72.2 % and 82.4 %,separately.Three-year patient survival was present in 81.5 % of DCD vs 78.9 % of DBD,which has no significant difference.The 3-year graft survival was lower inDCD than that in DBD (OR =0.73,95 % CI =0.56~0.94),69.5 % and 73.6%,separately.Conclusion DCD liver transplantation is associated with higher risks of biliary complications.But regarding the comparable general outcomes with DBD transplantation,DCD could be a source of liver.

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