Systematic review and meta-analysis of the role of aorto-hepatic conduits in liver transplant: Known knowns and known unknowns
Notice bibliographique
Résumé
BACKGROUND Aorto-hepatic conduits (AHCs) are an effective revascularization method for liver allografts when the native hepatic artery is unusable. Various studies have confirmed that outcomes with AHCs are inferior to those with native hepatic artery inflow. AIM To investigate the published evidence on the outcomes according to different inflow site for AHCs. METHODS A systematic search was conducted for studies reporting on AHCs in liver transplantation over the last 10 years (January 2014 onwards). Two independent reviewers selected articles, assessed quality, and evaluated bias in the included systematic reviews. The methodological quality of the included studies was assessed using the Newcastle-Ottawa Scale. The protocol was registered with PROSPERO (CRD42024545810). Review was conducted using the Preferred Reporting Items for Systematic Review and Meta-Analysis statement standards. RESULTS Fourteen studies identified a total of 32486 deceased donor liver transplants, of which 1136 (3.5%) required AHCs. The most frequent indications for AHC use included poor arterial flow, intimal dissections, and hepatic artery thrombosis. Among all AHCs, 207 (18.2%) were supra-coeliac (SC) AHCs, 738 (65.0%) infra-renal (IR) AHCs, 25 (2.2%) iliac artery conduits, and 166 (14.6%) had unspecified origins. Pooled analysis revealed comparable demographic characteristics. The median follow-up duration ranged from 18 to 52 months. There were no significant differences in early occlusions of AHCs [odds ratio (OR) = 0.94 (0.48, 1.84); P = 0.86], late occlusions of AHCs [OR = 0.46 (0.16, 1.32); P = 0.15], early allograft dysfunction [OR = 0.82 (0.46, 1.47); P = 0.51], biliary complications [OR = 1.10 (0.69, 1.76); P = 0.68], post-transplant renal replacement therapy (RRT) requirement [OR = 1.12 (0.72, 1.72); P = 0.62], and major surgical complications (Clavien-Dindo > 3b) [OR = 1.06 (0.70, 1.61); P = 0.79]. The median duration for graft occlusion was approximately 142 days, ranging from 13 to 3313 days. One-year graft and patient survival rates for SC conduits were 77% to 81.1% and 80% to 85.1%, respectively. For IR conduits, one-year graft and patient survival rates were 66% to 79.1% and 73% to 88.3%, respectively. Five-year graft and patient survival rates for SC conduits were 53.9% to 67% and 67.8% to 74%, respectively. For IR conduits, five-year graft and patient survival rates were 50% to 56% and 56% to 64.9%, respectively. CONCLUSION Considering these findings, there is no significant difference in early and late outcomes between SC and IR AHCs, although there is a discernible tendency towards higher late occlusion rates in the IR group.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,002 | 0,001 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».