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Meta-Analysis
. 2019 Mar;98(9):e14722.
doi: 10.1097/MD.0000000000014722.

The efficacy of extracorporeal membrane oxygenation in liver transplantation from non-heart-beating donors: A systemic review and meta-analysis

Jiang-Chen Peng  1 , Jia Ding, Zheng-Yu He, Yu-Xiao Deng, Shun-Peng Xing, Xian-Yuan Zhao, Zhe Li, Yi-Li Dai, Yuan Gao
Affiliations
Meta-Analysis

The efficacy of extracorporeal membrane oxygenation in liver transplantation from non-heart-beating donors: A systemic review and meta-analysis

Jiang-Chen Peng et al. Medicine (Baltimore). 2019 Mar.

Abstract

Background: A systematic review and meta-analysis was made to see whether extracorporeal membrane oxygenation (ECMO) in liver transplantation could improve non-heart-beating donors (NHBDs) recipients' outcomes compared with donors after brain death (DBDs) recipients.

Methods: We searched MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials for eligible studies. The study eligible criteria are cohort or case-control studies using ECMO in all NHBDs; studies involved a comparison group of DBDs; and studies evaluated 1-year graft and patient survival rate in NHBDs and DBDs groups.

Results: Four studies with 704 patients fulfilled the inclusion criteria. The pooled odds ratio (OR) of 1-year patient survival rate in NHBDs recipients compared with DBDs recipients was 0.8 (95% confidence interval [CI], 0.41-1.55). The pooled OR of 1-year graft survival rate in NHBDs recipients compared with DBDs recipients was 0.46 (95% CI, 0.26-0.81). NHBDs recipients were at greater risks to the occurrence of primary nonfunction (PNF) (OR = 7.12, 95% CI, 1.84-27.52) and ischemic cholangiopathy (IC) (OR = 9.46, 95% CI, 2.76-32.4) than DBDs recipients.

Conclusions: ECMO makes 1-year patient survival acceptable in NHBDs recipients. One-year graft survival rate was lower in NHBDs recipients than in DBDs recipients. Compared with DBDs recipients, the risks to develop PNF and IC were increased among NHBDs recipients.

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Conflict of interest statement

The authors have no conflicts of interest to disclose.

Figures

Figure 1
Figure 1
Flow diagram of studies identified in the systemic review.
Figure 2
Figure 2
Odds ratio of 1-year patient survival for NHBDs recipients versus BDDS recipients.
Figure 3
Figure 3
Odds ratio of 1-year graft survival for NHBDs recipients versus BDDS recipients.
Figure 4
Figure 4
Odds ratio of incidence of PNF for NHBDs recipients versus BDDS recipients.
Figure 5
Figure 5
Odds ratio of incidence of IC for NHBDs recipients versus BDDS recipients.
See this image and copyright information in PMC

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