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ABO-Incompatible Adult Living Donor Liver Transplantation in the Era of Rituximab: A Systematic Review and Meta-Analysis

AIM: The primary aim of this study is to compare the short- and long-term outcomes between ABO-incompatible (ABOi) adult living donor liver transplantation (ALDLT) with rituximab prophylaxis and ABO-compatible (ABOc) ALDLT. BACKGROUND: The strategy of ABOi liver transplantation (LT) was originated i...

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Autores principales: Yadav, Dipesh Kumar, Hua, Yong Fei, Bai, Xueli, Lou, Jianying, Que, Risheng, Gao, Shunling, Zhang, Yun, Wang, Ji, Xie, Qinfen, Edoo, Muhammad Ibrahim Alhadi, Chutturghoon, Vikram Kumar, Liang, Tingbo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6594289/
https://www.ncbi.nlm.nih.gov/pubmed/31285743
http://dx.doi.org/10.1155/2019/8589402
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author Yadav, Dipesh Kumar
Hua, Yong Fei
Bai, Xueli
Lou, Jianying
Que, Risheng
Gao, Shunling
Zhang, Yun
Wang, Ji
Xie, Qinfen
Edoo, Muhammad Ibrahim Alhadi
Chutturghoon, Vikram Kumar
Liang, Tingbo
author_facet Yadav, Dipesh Kumar
Hua, Yong Fei
Bai, Xueli
Lou, Jianying
Que, Risheng
Gao, Shunling
Zhang, Yun
Wang, Ji
Xie, Qinfen
Edoo, Muhammad Ibrahim Alhadi
Chutturghoon, Vikram Kumar
Liang, Tingbo
author_sort Yadav, Dipesh Kumar
collection PubMed
description AIM: The primary aim of this study is to compare the short- and long-term outcomes between ABO-incompatible (ABOi) adult living donor liver transplantation (ALDLT) with rituximab prophylaxis and ABO-compatible (ABOc) ALDLT. BACKGROUND: The strategy of ABOi liver transplantation (LT) was originated initially to increase the donor pool and to enable liver transplantation in emergency conditions. However, ABOi ALDLT remains a controversial approach in comparison to ABOc ALDLT. METHODS: PubMed, Embase, and the Cochrane Library study search were accomplished to recognize studies comparing ABOi and ABOc ALDLT. Meta-analyses were conducted based on the evaluation of heterogeneity using a fixed-effect model and a random-effect model to assess the short- and long-term outcomes following ABOi ALDLT with rituximab prophylaxis. RESULTS: Nine studies comprising a total of 3,922 patients (ABOi = 671 and ABOc = 3,251) were identified. There was no significant difference between ABOi and ABOc groups for 1-year, 3-year, and 5-year OS and graft survival, respectively. Moreover, 1-year and 3-year OS and DFS were similar between both groups for HCC patients. However, ABOi ALDLT had higher incidences of CMV infection, AMR, overall biliary complications, and biliary stricture than ABOc ALDLT and had other comparable postoperative complications. CONCLUSION: Our meta-analysis included studies comparing ABOi and ABOc ALDLT after the introduction of rituximab in a desensitization protocol for ABOi ALDLT. The results of ABOi ALDLT were comparable with those of ABOc ALDLT. However, biliary complications, CMV infection, and AMR remain a concern in the era of rituximab.
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spelling pubmed-65942892019-07-08 ABO-Incompatible Adult Living Donor Liver Transplantation in the Era of Rituximab: A Systematic Review and Meta-Analysis Yadav, Dipesh Kumar Hua, Yong Fei Bai, Xueli Lou, Jianying Que, Risheng Gao, Shunling Zhang, Yun Wang, Ji Xie, Qinfen Edoo, Muhammad Ibrahim Alhadi Chutturghoon, Vikram Kumar Liang, Tingbo Gastroenterol Res Pract Review Article AIM: The primary aim of this study is to compare the short- and long-term outcomes between ABO-incompatible (ABOi) adult living donor liver transplantation (ALDLT) with rituximab prophylaxis and ABO-compatible (ABOc) ALDLT. BACKGROUND: The strategy of ABOi liver transplantation (LT) was originated initially to increase the donor pool and to enable liver transplantation in emergency conditions. However, ABOi ALDLT remains a controversial approach in comparison to ABOc ALDLT. METHODS: PubMed, Embase, and the Cochrane Library study search were accomplished to recognize studies comparing ABOi and ABOc ALDLT. Meta-analyses were conducted based on the evaluation of heterogeneity using a fixed-effect model and a random-effect model to assess the short- and long-term outcomes following ABOi ALDLT with rituximab prophylaxis. RESULTS: Nine studies comprising a total of 3,922 patients (ABOi = 671 and ABOc = 3,251) were identified. There was no significant difference between ABOi and ABOc groups for 1-year, 3-year, and 5-year OS and graft survival, respectively. Moreover, 1-year and 3-year OS and DFS were similar between both groups for HCC patients. However, ABOi ALDLT had higher incidences of CMV infection, AMR, overall biliary complications, and biliary stricture than ABOc ALDLT and had other comparable postoperative complications. CONCLUSION: Our meta-analysis included studies comparing ABOi and ABOc ALDLT after the introduction of rituximab in a desensitization protocol for ABOi ALDLT. The results of ABOi ALDLT were comparable with those of ABOc ALDLT. However, biliary complications, CMV infection, and AMR remain a concern in the era of rituximab. Hindawi 2019-06-11 /pmc/articles/PMC6594289/ /pubmed/31285743 http://dx.doi.org/10.1155/2019/8589402 Text en Copyright © 2019 Dipesh Kumar Yadav et al. http://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 Review Article
Yadav, Dipesh Kumar
Hua, Yong Fei
Bai, Xueli
Lou, Jianying
Que, Risheng
Gao, Shunling
Zhang, Yun
Wang, Ji
Xie, Qinfen
Edoo, Muhammad Ibrahim Alhadi
Chutturghoon, Vikram Kumar
Liang, Tingbo
ABO-Incompatible Adult Living Donor Liver Transplantation in the Era of Rituximab: A Systematic Review and Meta-Analysis
title ABO-Incompatible Adult Living Donor Liver Transplantation in the Era of Rituximab: A Systematic Review and Meta-Analysis
title_full ABO-Incompatible Adult Living Donor Liver Transplantation in the Era of Rituximab: A Systematic Review and Meta-Analysis
title_fullStr ABO-Incompatible Adult Living Donor Liver Transplantation in the Era of Rituximab: A Systematic Review and Meta-Analysis
title_full_unstemmed ABO-Incompatible Adult Living Donor Liver Transplantation in the Era of Rituximab: A Systematic Review and Meta-Analysis
title_short ABO-Incompatible Adult Living Donor Liver Transplantation in the Era of Rituximab: A Systematic Review and Meta-Analysis
title_sort abo-incompatible adult living donor liver transplantation in the era of rituximab: a systematic review and meta-analysis
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6594289/
https://www.ncbi.nlm.nih.gov/pubmed/31285743
http://dx.doi.org/10.1155/2019/8589402
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