Reperfusion of liver graft during transplantation: techniques used in transplant centres within Eurotransplant and meta-analysis of the literature
2013 | journal article. A publication with affiliation to the University of Göttingen.
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Reperfusion of liver graft during transplantation: techniques used in transplant centres within Eurotransplant and meta-analysis of the literature
Manzini, G.; Kremer, M.; Houben, P.; Gondan, M.; Bechstein, W. O.; Becker, T. & Berlakovich, G. A. et al. (2013)
Transplant International, 26(5) pp. 508-516. DOI: https://doi.org/10.1111/tri.12083
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- Authors
- Manzini, Giulia; Kremer, Michael; Houben, Philipp; Gondan, Matthias; Bechstein, Wolf O.; Becker, Thomas; Berlakovich, Gabriela A.; Friess, Helmut; Guba, Markus; Hohenberger, Werner; Ijzermans, Jan N. M.; Jonas, Sven; Kalff, Joerg C.; Klar, Ernst; Klempnauer, Juergen; Lerut, Jan; Lippert, Hans; Lorf, Thomas; Nadalin, Silvio; Nashan, Bjoern; Otto, Gerd; Paul, Andreas; Pirenne, Jacques; Pratschke, Johann; Ringers, Jan; Rogiers, Xavier; Schilling, Martin Karl; Seehofer, Daniel; Senninger, Norbert; Settmacher, Utz; Stippel, Dirk L.; Tscheliessnigg, Karlheinz; Ysebaert, Dirk; Binder, Heidrun; Schemmer, Peter
- Abstract
- It remains unclear which liver graft reperfusion technique leads to the best outcome following transplantation. An online survey was sent to all transplant centres (n=37) within Eurotransplant (ET) to collect information on their technique used for reperfusion of liver grafts. Furthermore, a systematic review of all literature was performed and a meta-analysis was conducted based on patients' mortality, number of retransplantations and incidence of biliary complications, depending on the technique used. Of the 28 evaluated centres, 11 (39%) reported performing simultaneous reperfusion (SIMR), 13 (46%) perform initial portal vein reperfusion (IPR), 1 (4%) performs an initial hepatic artery reperfusion (IAR) and 3 (11%) perform retrograde reperfusion (RETR). In 21 centres (75%), one reperfusion technique is used as a standard, but in only one centre is this decision based on available literature. Twenty centres (71%) said they would agree to participate in randomized controlled trials (RCT) if required. For meta-analysis, IAR vs. IPR, SIMR vs. IPR and RETR vs. IPR were compared. There was no difference between any of the techniques compared. There is no consensus on a preferable reperfusion technique. Available evidence does not help in the decision-making process. There is thus an urgent need for multicentric RCTs.
- Issue Date
- 2013
- Status
- published
- Publisher
- Wiley-blackwell
- Journal
- Transplant International
- ISSN
- 0934-0874