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Meta-Analysis
. 2022 Feb;104(2):88-94.
doi: 10.1308/rcsann.2021.0103. Epub 2021 Sep 6.

Combined heart and liver transplantation: an updated systematic review

M Frountzas  1 , N Karampetsou  1 , C Nikolaou  1 , D Schizas  1 , D Tsapralis  2 , D Avgerinos  3 , K Toutouzas  1
Affiliations
Meta-Analysis

Combined heart and liver transplantation: an updated systematic review

M Frountzas et al. Ann R Coll Surg Engl. 2022 Feb.

Abstract

Introduction: Combined heart and liver transplantation (CHLT) is one of the most complex procedures of surgery that has been implemented in the last 35 years. The aim of our meta-analysis was to investigate the safety and efficacy of CHLT.

Materials: The meta-analysis was designed according to PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) and AMSTAR (A MeaSurement Tool to Assess systematic Reviews) recommendations. A literature search was conducted up to April 2020 using the MEDLINE,® SCOPUS,® ClinicalTrials.gov, Embase™, Cochrane Central Register of Controlled Trials and Google Scholar™ databases.

Results: Our meta-analysis included 16 studies with 860 patients. The mortality rate following CHLT was 14.1%. One and five-year survival rates were 85.3% and 71.4% while the heart and liver rejection rates were 6.1% and 9.1% respectively. The hospital stay was 25.8 days and the intensive care unit stay was 9.9 days. Pooled values were also calculated for cardiopulmonary bypass duration, units of transfused red blood cells and fresh frozen plasma, postoperative infection rate, mechanical ventilation rate and follow-up duration.

Conclusions: Despite its complexity, CHLT is a safe and effective procedure for the management of lethal diseases that lead to progressive heart and/or liver failure. Nevertheless, there must be strict adherence to the indications for surgery, and future studies should compare CHLT with isolated cardiac and hepatic transplantations.

Keywords: Combined; Heart; Liver; Meta-analysis; Transplantation.

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Figures

Figure 1
Figure 1
Forest plots showing a pooled mortality rate of 14.1%, and pooled 1-year and 5-year survival rates of 85.3% and 71.4% respectively
See this image and copyright information in PMC

Comment in

  • Combined heart-liver transplantation in the UK.
    Dronavalli V, Clark S. Dronavalli V, et al. Ann R Coll Surg Engl. 2023 May;105(5):476. doi: 10.1308/rcsann.2022.0084. Epub 2022 Oct 20. Ann R Coll Surg Engl. 2023. PMID: 36263908 Free PMC article. No abstract available.

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