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Adult split liver transplantation: A PRISMA-compliant Chinese single-center retrospective case-control study
Although pediatric split liver transplantation (SLT) has been proven safe and the waitlist mortality rate has been successfully reduced, the safety of adult SLT has not been confirmed. Using 1:2 matching, 47 recipients who underwent adult SLT were matched to 94 of 743 recipients who underwent adult...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Lippincott Williams & Wilkins
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7748205/ https://www.ncbi.nlm.nih.gov/pubmed/33371134 http://dx.doi.org/10.1097/MD.0000000000023750 |
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author | Kong, Lingxiang Lv, Tao Yang, Jian Jiang, Li Yang, Jiayin |
author_facet | Kong, Lingxiang Lv, Tao Yang, Jian Jiang, Li Yang, Jiayin |
author_sort | Kong, Lingxiang |
collection | PubMed |
description | Although pediatric split liver transplantation (SLT) has been proven safe and the waitlist mortality rate has been successfully reduced, the safety of adult SLT has not been confirmed. Using 1:2 matching, 47 recipients who underwent adult SLT were matched to 94 of 743 recipients who underwent adult whole graft liver transplantation (WGLT). Eventually, 141 recipients were included in the case-control study. Subgroup analysis of 43 recipients in the SLT group was performed based on the presence of the middle hepatic vein (MHV) in the grafts. No significant differences in 5-year survival (80.8% vs 81.6%, P = .465) were observed between the adult SLT and WGLT groups. However, compared to recipients in the WGLT group, those in the SLT group had more Clavien–Dindo grade III-V complications, longer hospitalization duration, and higher mortality within 45 days. Furthermore, on multivariate analysis, 45-day postoperative mortality in recipients in the SLT group was mainly affected by hyperbilirubinemia within postoperative day (POD) 7–14, surgery time, and intraoperative blood loss. Subgroup analysis showed no significant differences in hyperbilirubinemia within POD 7–14, complications, and survival rate between SLT(MHV(+)) and SLT(MHV [−]). Adult SLT is safe and effective based on long-term survival rates; however, a reduction in the incidence of short-term complications is required. Non-obstructive hyperbilirubinemia within POD 7 to 14 is an independent predictor of short-term mortality after SLT. |
format | Online Article Text |
id | pubmed-7748205 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Lippincott Williams & Wilkins |
record_format | MEDLINE/PubMed |
spelling | pubmed-77482052020-12-21 Adult split liver transplantation: A PRISMA-compliant Chinese single-center retrospective case-control study Kong, Lingxiang Lv, Tao Yang, Jian Jiang, Li Yang, Jiayin Medicine (Baltimore) 7100 Although pediatric split liver transplantation (SLT) has been proven safe and the waitlist mortality rate has been successfully reduced, the safety of adult SLT has not been confirmed. Using 1:2 matching, 47 recipients who underwent adult SLT were matched to 94 of 743 recipients who underwent adult whole graft liver transplantation (WGLT). Eventually, 141 recipients were included in the case-control study. Subgroup analysis of 43 recipients in the SLT group was performed based on the presence of the middle hepatic vein (MHV) in the grafts. No significant differences in 5-year survival (80.8% vs 81.6%, P = .465) were observed between the adult SLT and WGLT groups. However, compared to recipients in the WGLT group, those in the SLT group had more Clavien–Dindo grade III-V complications, longer hospitalization duration, and higher mortality within 45 days. Furthermore, on multivariate analysis, 45-day postoperative mortality in recipients in the SLT group was mainly affected by hyperbilirubinemia within postoperative day (POD) 7–14, surgery time, and intraoperative blood loss. Subgroup analysis showed no significant differences in hyperbilirubinemia within POD 7–14, complications, and survival rate between SLT(MHV(+)) and SLT(MHV [−]). Adult SLT is safe and effective based on long-term survival rates; however, a reduction in the incidence of short-term complications is required. Non-obstructive hyperbilirubinemia within POD 7 to 14 is an independent predictor of short-term mortality after SLT. Lippincott Williams & Wilkins 2020-12-18 /pmc/articles/PMC7748205/ /pubmed/33371134 http://dx.doi.org/10.1097/MD.0000000000023750 Text en Copyright © 2020 the Author(s). Published by Wolters Kluwer Health, Inc. http://creativecommons.org/licenses/by-nc/4.0 This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial License 4.0 (CCBY-NC), where it is permissible to download, share, remix, transform, and buildup the work provided it is properly cited. The work cannot be used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc/4.0 |
spellingShingle | 7100 Kong, Lingxiang Lv, Tao Yang, Jian Jiang, Li Yang, Jiayin Adult split liver transplantation: A PRISMA-compliant Chinese single-center retrospective case-control study |
title | Adult split liver transplantation: A PRISMA-compliant Chinese single-center retrospective case-control study |
title_full | Adult split liver transplantation: A PRISMA-compliant Chinese single-center retrospective case-control study |
title_fullStr | Adult split liver transplantation: A PRISMA-compliant Chinese single-center retrospective case-control study |
title_full_unstemmed | Adult split liver transplantation: A PRISMA-compliant Chinese single-center retrospective case-control study |
title_short | Adult split liver transplantation: A PRISMA-compliant Chinese single-center retrospective case-control study |
title_sort | adult split liver transplantation: a prisma-compliant chinese single-center retrospective case-control study |
topic | 7100 |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7748205/ https://www.ncbi.nlm.nih.gov/pubmed/33371134 http://dx.doi.org/10.1097/MD.0000000000023750 |
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