Identifying the Superior Reperfusion Technique in Liver Transplantation: A Network Meta-Analysis
Objective. To investigate the clinical effects of different reperfusion techniques in liver transplantation based on network meta-analysis. Method. Literature retrieval was conducted in globally recognized databases, namely, MEDLINE, EMBASE, and Cochrane Central, to address relative randomized contr...
Saved in:
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2019-01-01
|
| Series: | Gastroenterology Research and Practice |
| Online Access: | http://dx.doi.org/10.1155/2019/9034263 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849414216114503680 |
|---|---|
| author | Yao Yao Ping Wu Tao Guo |
| author_facet | Yao Yao Ping Wu Tao Guo |
| author_sort | Yao Yao |
| collection | DOAJ |
| description | Objective. To investigate the clinical effects of different reperfusion techniques in liver transplantation based on network meta-analysis. Method. Literature retrieval was conducted in globally recognized databases, namely, MEDLINE, EMBASE, and Cochrane Central, to address relative randomized controlled trials (RCTs) investigating the clinical effects of respective reperfusion techniques in liver transplantation. Short- and long-term parametric data, including ICU stay, dysfunction rate (DFR), biliary complications (BC), 1-year graft survival (GS), and patient survival (PS), were quantitatively pooled and estimated based on the Bayesian theorem. The P values of surface under the cumulative ranking (SUCRA) probabilities regarding each parameter were calculated and ranked by various techniques. The Grades of Recommendations Assessment, Development and Evaluation (GRADE) criteria were utilized for the recommendations of evidence from pairwise direct comparisons. Results. Seven RCTs containing 6 different techniques were finally included for network meta-analysis. The results indicated that retrograde vena cava (RVC) reperfusion possessed the highest possibility of revealing the best clinical effects on DFR (SUCRA, P=0.93), ICU stay (SUCRA, P=0.76), and GS (SUCRA, P=0.44), while portal-arterial reperfusion (simultaneous initialize) seemed to exhibit the most benefits in reducing BC (SUCRA, P=0.67) and enhancing PS rate (SUCRA, P=0.48). Moreover, sensitivity analysis with the inconsistency approach clarified the reliability of the main results, and the evidence of the most direct comparisons was ranked low or very low. Conclusions. Current evidence demonstrated that RVC and portal-arterial reperfusion (simultaneously initialized) revealed superior clinical effects, compared to other interventions. Investigation of these 2 techniques should be a future research direction, and more high-quality RCTs are expected. |
| format | Article |
| id | doaj-art-6e3879c4aa854663ba3d4c8679a78a0b |
| institution | Kabale University |
| issn | 1687-6121 1687-630X |
| language | English |
| publishDate | 2019-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Gastroenterology Research and Practice |
| spelling | doaj-art-6e3879c4aa854663ba3d4c8679a78a0b2025-08-20T03:33:54ZengWileyGastroenterology Research and Practice1687-61211687-630X2019-01-01201910.1155/2019/90342639034263Identifying the Superior Reperfusion Technique in Liver Transplantation: A Network Meta-AnalysisYao Yao0Ping Wu1Tao Guo2School of Medicine, Huanggang Polytechnic College, Huanggang 438002, ChinaDepartment of Hepatobiliary and Pancreatic Surgery, Zhongnan Hospital of Wuhan University, Wuhan 430071, ChinaDepartment of Hepatobiliary and Pancreatic Surgery, Zhongnan Hospital of Wuhan University, Wuhan 430071, ChinaObjective. To investigate the clinical effects of different reperfusion techniques in liver transplantation based on network meta-analysis. Method. Literature retrieval was conducted in globally recognized databases, namely, MEDLINE, EMBASE, and Cochrane Central, to address relative randomized controlled trials (RCTs) investigating the clinical effects of respective reperfusion techniques in liver transplantation. Short- and long-term parametric data, including ICU stay, dysfunction rate (DFR), biliary complications (BC), 1-year graft survival (GS), and patient survival (PS), were quantitatively pooled and estimated based on the Bayesian theorem. The P values of surface under the cumulative ranking (SUCRA) probabilities regarding each parameter were calculated and ranked by various techniques. The Grades of Recommendations Assessment, Development and Evaluation (GRADE) criteria were utilized for the recommendations of evidence from pairwise direct comparisons. Results. Seven RCTs containing 6 different techniques were finally included for network meta-analysis. The results indicated that retrograde vena cava (RVC) reperfusion possessed the highest possibility of revealing the best clinical effects on DFR (SUCRA, P=0.93), ICU stay (SUCRA, P=0.76), and GS (SUCRA, P=0.44), while portal-arterial reperfusion (simultaneous initialize) seemed to exhibit the most benefits in reducing BC (SUCRA, P=0.67) and enhancing PS rate (SUCRA, P=0.48). Moreover, sensitivity analysis with the inconsistency approach clarified the reliability of the main results, and the evidence of the most direct comparisons was ranked low or very low. Conclusions. Current evidence demonstrated that RVC and portal-arterial reperfusion (simultaneously initialized) revealed superior clinical effects, compared to other interventions. Investigation of these 2 techniques should be a future research direction, and more high-quality RCTs are expected.http://dx.doi.org/10.1155/2019/9034263 |
| spellingShingle | Yao Yao Ping Wu Tao Guo Identifying the Superior Reperfusion Technique in Liver Transplantation: A Network Meta-Analysis Gastroenterology Research and Practice |
| title | Identifying the Superior Reperfusion Technique in Liver Transplantation: A Network Meta-Analysis |
| title_full | Identifying the Superior Reperfusion Technique in Liver Transplantation: A Network Meta-Analysis |
| title_fullStr | Identifying the Superior Reperfusion Technique in Liver Transplantation: A Network Meta-Analysis |
| title_full_unstemmed | Identifying the Superior Reperfusion Technique in Liver Transplantation: A Network Meta-Analysis |
| title_short | Identifying the Superior Reperfusion Technique in Liver Transplantation: A Network Meta-Analysis |
| title_sort | identifying the superior reperfusion technique in liver transplantation a network meta analysis |
| url | http://dx.doi.org/10.1155/2019/9034263 |
| work_keys_str_mv | AT yaoyao identifyingthesuperiorreperfusiontechniqueinlivertransplantationanetworkmetaanalysis AT pingwu identifyingthesuperiorreperfusiontechniqueinlivertransplantationanetworkmetaanalysis AT taoguo identifyingthesuperiorreperfusiontechniqueinlivertransplantationanetworkmetaanalysis |