Donation after cardiac death versus donation after brain death for liver transplantation: a meta-analysis
10.3760/cma.j.issn.0254-1785.2014.02.006
- VernacularTitle:比较心脏死亡器官捐赠与脑死亡器官捐赠供肝肝移植预后的荟萃分析
- Author:
Xiaoli FAN
;
Qifa YE
;
Yanfeng WANG
;
Ling LI
;
Zibiao ZHONG
;
Xuan LI
;
Lin FAN
- Publication Type:Journal Article
- Keywords:
Liver transplantation;
Donation after cardiac death;
Donation after brain death;
Complication;
Graft survival;
Meta-analysis;
Systematic review
- From:
Chinese Journal of Organ Transplantation
2014;35(2):86-93
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare the outcome of donation after cardiac death (DCD) versus donation after brain death (DBD) for liver transplantation.Method Such databases as PubMed,Cochrane Central Register of Controlled Trials (CENTRAL),EMbase,the ISI Web of Knowledge databases and CBMdisk were searched from Month 1990 to March 2011 for collecting the randomized controlled trials (RCTs),case control studies and cohort analysis about DCD versus DBD for liver transplantation,and the references of those trials were also searched by hand.After study selection,assessment and data extraction conducted by two reviewers independently,meta-analyses were performed by using the RevManS.1 software.The quality of evidence was assessed by using the GRADEpro software.Result DCD group had similar MELD of recipients with DBD group before operation [Z =1.37,95％ CI(-2.25,0.26),P =0.17],and DCD group got shorter cold ischemia time than DBD group [Z=2.26,95％CI(-1.76,-0.12),P =0.02].DCD group had higher hiliary complication incidence [Z =6.37,95％ CI(1.89,3.31),P＜0.000 01],higher vascular complication incidence [Z =2.14,95％ CI(1.03,2.17),P =0.03],higher liver primary non-function (PNF) incidence [Z =4.43,95％ CI (2.02,6.17),P＜0.000 01],lower 1-year graft survival rate [Z =3.78,95％ CI(0.84,0.94),P =0.0002] and lower 3 year graft survival rate[Z=2.54,95％ CI(0.73,0.96),P =0.01] than DBD group.The quality of the result was verified from low to moderate.Conclusion Liver transplantation using DCD had higher incidence of complications and lower 1-year and 3-year graft survival rate than DBD.For the poor quality of the original studies,a prudent choice is suggested.More randomized controlled trials are needed.
