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Clinical Outcomes after Liver Transplantation for Hepatorenal Syndrome: A Systematic Review and Meta-Analysis

AIMS: Hepatorenal syndrome (HRS) decreases survival of cirrhotic patients. The outcomes of HRS after liver transplantation (LT) were inconsistently reported. We conducted a systematic review and meta-analysis study to estimate the post-LT rates of death and HRS reversal. METHODS: A thorough search o...

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Autores principales: Utako, Piyapon, Emyoo, Thapanakul, Anothaisintawee, Thunyarat, Yamashiki, Noriyo, Thakkinstian, Ammarin, Sobhonslidsuk, Abhasnee
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5994306/
https://www.ncbi.nlm.nih.gov/pubmed/29992152
http://dx.doi.org/10.1155/2018/5362810
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author Utako, Piyapon
Emyoo, Thapanakul
Anothaisintawee, Thunyarat
Yamashiki, Noriyo
Thakkinstian, Ammarin
Sobhonslidsuk, Abhasnee
author_facet Utako, Piyapon
Emyoo, Thapanakul
Anothaisintawee, Thunyarat
Yamashiki, Noriyo
Thakkinstian, Ammarin
Sobhonslidsuk, Abhasnee
author_sort Utako, Piyapon
collection PubMed
description AIMS: Hepatorenal syndrome (HRS) decreases survival of cirrhotic patients. The outcomes of HRS after liver transplantation (LT) were inconsistently reported. We conducted a systematic review and meta-analysis study to estimate the post-LT rates of death and HRS reversal. METHODS: A thorough search of literatures was performed on PubMed, Scopus, and conference abstracts for reports on post-LT survival and HRS reversal. Data for the posttransplant rates of HRS reversal, death, and acute rejection were extracted. The rates were pooled using inverse variance method if there was no heterogeneity between studies. Otherwise, the random effect model was applied. RESULTS: Twenty studies were included. Pooling HRS reversal rates indicated high heterogeneity with a pooled rate of 0.834 (95% CI: 0.709–0.933). The pooled overall death rates for HRS and non-HRS after LT were 0.25 (95% confidence interval (CI): 0.18–0.33) and 0.19 (95% CI: 0.14–0.26). The risk ratio of death between HRS and non-HRS patients was 1.29 (95% CI: 1.14–1.47, P < 0.001). The probability of death at 1, 3, and 5 years tended to be higher among HRS. CONCLUSIONS: HRS is reversible in about 83% of patients after LT. However, the posttransplant mortality rate of HRS patients is still increased.
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spelling pubmed-59943062018-07-10 Clinical Outcomes after Liver Transplantation for Hepatorenal Syndrome: A Systematic Review and Meta-Analysis Utako, Piyapon Emyoo, Thapanakul Anothaisintawee, Thunyarat Yamashiki, Noriyo Thakkinstian, Ammarin Sobhonslidsuk, Abhasnee Biomed Res Int Research Article AIMS: Hepatorenal syndrome (HRS) decreases survival of cirrhotic patients. The outcomes of HRS after liver transplantation (LT) were inconsistently reported. We conducted a systematic review and meta-analysis study to estimate the post-LT rates of death and HRS reversal. METHODS: A thorough search of literatures was performed on PubMed, Scopus, and conference abstracts for reports on post-LT survival and HRS reversal. Data for the posttransplant rates of HRS reversal, death, and acute rejection were extracted. The rates were pooled using inverse variance method if there was no heterogeneity between studies. Otherwise, the random effect model was applied. RESULTS: Twenty studies were included. Pooling HRS reversal rates indicated high heterogeneity with a pooled rate of 0.834 (95% CI: 0.709–0.933). The pooled overall death rates for HRS and non-HRS after LT were 0.25 (95% confidence interval (CI): 0.18–0.33) and 0.19 (95% CI: 0.14–0.26). The risk ratio of death between HRS and non-HRS patients was 1.29 (95% CI: 1.14–1.47, P < 0.001). The probability of death at 1, 3, and 5 years tended to be higher among HRS. CONCLUSIONS: HRS is reversible in about 83% of patients after LT. However, the posttransplant mortality rate of HRS patients is still increased. Hindawi 2018-05-24 /pmc/articles/PMC5994306/ /pubmed/29992152 http://dx.doi.org/10.1155/2018/5362810 Text en Copyright © 2018 Piyapon Utako et al. https://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Utako, Piyapon
Emyoo, Thapanakul
Anothaisintawee, Thunyarat
Yamashiki, Noriyo
Thakkinstian, Ammarin
Sobhonslidsuk, Abhasnee
Clinical Outcomes after Liver Transplantation for Hepatorenal Syndrome: A Systematic Review and Meta-Analysis
title Clinical Outcomes after Liver Transplantation for Hepatorenal Syndrome: A Systematic Review and Meta-Analysis
title_full Clinical Outcomes after Liver Transplantation for Hepatorenal Syndrome: A Systematic Review and Meta-Analysis
title_fullStr Clinical Outcomes after Liver Transplantation for Hepatorenal Syndrome: A Systematic Review and Meta-Analysis
title_full_unstemmed Clinical Outcomes after Liver Transplantation for Hepatorenal Syndrome: A Systematic Review and Meta-Analysis
title_short Clinical Outcomes after Liver Transplantation for Hepatorenal Syndrome: A Systematic Review and Meta-Analysis
title_sort clinical outcomes after liver transplantation for hepatorenal syndrome: a systematic review and meta-analysis
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5994306/
https://www.ncbi.nlm.nih.gov/pubmed/29992152
http://dx.doi.org/10.1155/2018/5362810
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