Compared efficacy of preservation solutions on the outcome of liver transplantation: Meta-analysis

Ágnes Lilla Szilágyi, Péter Mátrai, Péter Hegyi, Eszter Tuboly, Daniella Pécz, András Garami, Margit Solymár, Erika Pétervári, M. Balaskó, G. Verès, L. Czopf, Bastian Wobbe, Dorottya Szabó, Juliane Wagner, Petra Hartmann

Research output: Article

3 Citations (Scopus)

Abstract

AIM To compare the effects of the four most commonly used preservation solutions on the outcome of liver transplantations. METHODS A systematic literature search was performed using MEDLINE, Scopus, EMBASE and the Cochrane Library databases up to January 31st, 2017. The inclusion criteria were comparative, randomized controlled trials (RCTs) for deceased donor liver (DDL) allografts with adult and pediatric donors using the gold standard University of Wisconsin (UW) solution or histidine-tryptophan-ketoglutarate (HTK), Celsior (CS) and Institut Georges Lopez (IGL-1) solutions. Fifteen RCTs (1830 livers) were included; the primary outcomes were primary non-function (PNF) and one-year post-transplant graft survival (OGS-1). RESULTS All trials were homogenous with respect to donor and recipient characteristics. There was no statistical difference in the incidence of PNF with the use of UW, HTK, CS and IGL-1 (RR = 0.02, 95%CI: 0.01-0.03, P = 0.356). Comparing OGS-1 also failed to reveal any difference between UW, HTK, CS and IGL-1 (RR = 0.80, 95%CI: 0.80-0.80, P = 0.369). Two trials demonstrated higher PNF levels for UW in comparison with the HTK group, and individual studies described higher rates of biliary complications where HTK and CS were used compared to the UW and IGL-1 solutions. However, the meta-analysis of the data did not prove a statistically significant difference: the UW, CS, HTK and IGL-1 solutions were associated with nearly equivalent outcomes. CONCLUSION Alternative solutions for UW yield the same degree of safety and effectiveness for the preservation of DDLs, but further well-designed clinical trials are warranted.

Original languageEnglish
Pages (from-to)1812-1824
Number of pages13
JournalWorld Journal of Gastroenterology
Volume24
Issue number16
DOIs
Publication statusPublished - ápr. 28 2018

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Liver Transplantation
Meta-Analysis
Histidine
Tryptophan
Randomized Controlled Trials
Liver
Graft Survival
MEDLINE
Libraries
Allografts
Celsior
Clinical Trials
Databases
Pediatrics
Transplants
Safety
IGL-1 solution
Incidence

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Compared efficacy of preservation solutions on the outcome of liver transplantation : Meta-analysis. / Szilágyi, Ágnes Lilla; Mátrai, Péter; Hegyi, Péter; Tuboly, Eszter; Pécz, Daniella; Garami, András; Solymár, Margit; Pétervári, Erika; Balaskó, M.; Verès, G.; Czopf, L.; Wobbe, Bastian; Szabó, Dorottya; Wagner, Juliane; Hartmann, Petra.

In: World Journal of Gastroenterology, Vol. 24, No. 16, 28.04.2018, p. 1812-1824.

Research output: Article

Szilágyi, ÁL, Mátrai, P, Hegyi, P, Tuboly, E, Pécz, D, Garami, A, Solymár, M, Pétervári, E, Balaskó, M, Verès, G, Czopf, L, Wobbe, B, Szabó, D, Wagner, J & Hartmann, P 2018, 'Compared efficacy of preservation solutions on the outcome of liver transplantation: Meta-analysis', World Journal of Gastroenterology, vol. 24, no. 16, pp. 1812-1824. https://doi.org/10.3748/wjg.v24.i16.1812
Szilágyi, Ágnes Lilla ; Mátrai, Péter ; Hegyi, Péter ; Tuboly, Eszter ; Pécz, Daniella ; Garami, András ; Solymár, Margit ; Pétervári, Erika ; Balaskó, M. ; Verès, G. ; Czopf, L. ; Wobbe, Bastian ; Szabó, Dorottya ; Wagner, Juliane ; Hartmann, Petra. / Compared efficacy of preservation solutions on the outcome of liver transplantation : Meta-analysis. In: World Journal of Gastroenterology. 2018 ; Vol. 24, No. 16. pp. 1812-1824.
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T2 - Meta-analysis

AU - Szilágyi, Ágnes Lilla

AU - Mátrai, Péter

AU - Hegyi, Péter

AU - Tuboly, Eszter

AU - Pécz, Daniella

AU - Garami, András

AU - Solymár, Margit

AU - Pétervári, Erika

AU - Balaskó, M.

AU - Verès, G.

AU - Czopf, L.

AU - Wobbe, Bastian

AU - Szabó, Dorottya

AU - Wagner, Juliane

AU - Hartmann, Petra

PY - 2018/4/28

Y1 - 2018/4/28

N2 - AIM To compare the effects of the four most commonly used preservation solutions on the outcome of liver transplantations. METHODS A systematic literature search was performed using MEDLINE, Scopus, EMBASE and the Cochrane Library databases up to January 31st, 2017. The inclusion criteria were comparative, randomized controlled trials (RCTs) for deceased donor liver (DDL) allografts with adult and pediatric donors using the gold standard University of Wisconsin (UW) solution or histidine-tryptophan-ketoglutarate (HTK), Celsior (CS) and Institut Georges Lopez (IGL-1) solutions. Fifteen RCTs (1830 livers) were included; the primary outcomes were primary non-function (PNF) and one-year post-transplant graft survival (OGS-1). RESULTS All trials were homogenous with respect to donor and recipient characteristics. There was no statistical difference in the incidence of PNF with the use of UW, HTK, CS and IGL-1 (RR = 0.02, 95%CI: 0.01-0.03, P = 0.356). Comparing OGS-1 also failed to reveal any difference between UW, HTK, CS and IGL-1 (RR = 0.80, 95%CI: 0.80-0.80, P = 0.369). Two trials demonstrated higher PNF levels for UW in comparison with the HTK group, and individual studies described higher rates of biliary complications where HTK and CS were used compared to the UW and IGL-1 solutions. However, the meta-analysis of the data did not prove a statistically significant difference: the UW, CS, HTK and IGL-1 solutions were associated with nearly equivalent outcomes. CONCLUSION Alternative solutions for UW yield the same degree of safety and effectiveness for the preservation of DDLs, but further well-designed clinical trials are warranted.

AB - AIM To compare the effects of the four most commonly used preservation solutions on the outcome of liver transplantations. METHODS A systematic literature search was performed using MEDLINE, Scopus, EMBASE and the Cochrane Library databases up to January 31st, 2017. The inclusion criteria were comparative, randomized controlled trials (RCTs) for deceased donor liver (DDL) allografts with adult and pediatric donors using the gold standard University of Wisconsin (UW) solution or histidine-tryptophan-ketoglutarate (HTK), Celsior (CS) and Institut Georges Lopez (IGL-1) solutions. Fifteen RCTs (1830 livers) were included; the primary outcomes were primary non-function (PNF) and one-year post-transplant graft survival (OGS-1). RESULTS All trials were homogenous with respect to donor and recipient characteristics. There was no statistical difference in the incidence of PNF with the use of UW, HTK, CS and IGL-1 (RR = 0.02, 95%CI: 0.01-0.03, P = 0.356). Comparing OGS-1 also failed to reveal any difference between UW, HTK, CS and IGL-1 (RR = 0.80, 95%CI: 0.80-0.80, P = 0.369). Two trials demonstrated higher PNF levels for UW in comparison with the HTK group, and individual studies described higher rates of biliary complications where HTK and CS were used compared to the UW and IGL-1 solutions. However, the meta-analysis of the data did not prove a statistically significant difference: the UW, CS, HTK and IGL-1 solutions were associated with nearly equivalent outcomes. CONCLUSION Alternative solutions for UW yield the same degree of safety and effectiveness for the preservation of DDLs, but further well-designed clinical trials are warranted.

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KW - Meta-analysis

KW - One-year post-transplant graft survival

KW - Preservation solution

KW - Primary non-function

KW - Systematic review

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