Garzali Ibrahim Umar, Akbulut Sami, Aloun Ali, Naffa Motaz, Aksoy Fuat
Department of Surgery, Aminu Kano Teaching Hospital, Kano 700101, Nigeria.
Department of Surgery and Liver Transplant Institute, Inonu University Faculty of Medicine, Malatya 44280, Turkey.
World J Gastrointest Surg. 2023 Jul 27;15(7):1522-1531. doi: 10.4240/wjgs.v15.i7.1522.
The outcomes of liver transplantation (LT) from different grafts have been studied individually and in combination, but the reports were conflicting with some researchers finding no difference in both short-term and long-term outcomes between the deceased donor split LT (DD-SLT) and living donor LT (LDLT).
To compare the outcomes of DD-SLT and LDLT we performed this systematic review and meta-analysis.
This systematic review was performed in compliance with the Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines. The following databases were searched for articles comparing outcomes of DD-SLT and LDLT: PubMed; Google Scholar; Embase; Cochrane Central Register of Controlled Trials; the Cochrane Database of Systematic Reviews; and (https://www.referencecitationanalysis.com/). The search terms used were: "liver transplantation;" "liver transplant;" "split liver transplant;" "living donor liver transplant;" "partial liver transplant;" "partial liver graft;" "ex vivo splitting;" and "in vivo splitting."
Ten studies were included for the data synthesis and meta-analysis. There were a total of 4836 patients. The overall survival rate at 1 year, 3 years and 5 years was superior in patients that received LDLT compared to DD-SLT. At 1 year, the hazard ratios was 1.44 (95% confidence interval: 1.16-1.78; = 0.001). The graft survival rate at 3 years and 5 years was superior in the LDLT group (3 year hazard ratio: 1.28; 95% confidence interval: 1.01-1.63; = 0.04).
This meta-analysis showed that LDLT has better graft survival and overall survival when compared to DD-SLT.
已对不同移植物肝移植（LT）的结果进行了单独研究和联合研究，但报告结果相互矛盾，一些研究人员发现，在已故供体劈离式肝移植（DD-SLT）和活体供体肝移植（LDLT）之间，短期和长期结果均无差异。
为比较DD-SLT和LDLT的结果，我们进行了这项系统评价和荟萃分析。
本系统评价按照系统评价和荟萃分析的首选报告项目指南进行。检索了以下数据库以查找比较DD-SLT和LDLT结果的文章：PubMed；谷歌学术；Embase；Cochrane对照试验中央注册库；Cochrane系统评价数据库；以及（https://www.referencecitationanalysis.com/）。使用的检索词为：“肝移植”；“肝移植术”；“劈离式肝移植”；“活体供体肝移植”；“部分肝移植”；“部分肝移植物”；“体外劈离”；和“体内劈离”。
纳入10项研究进行数据合成和荟萃分析。共有4836例患者。与接受DD-SLT的患者相比，接受LDLT的患者1年、3年和5年的总生存率更高。1年时，风险比为1.44（95%置信区间：1.16 - 1.78；P = 0.001）。LDLT组3年和5年的移植物生存率更高（3年风险比：1.28；95%置信区间：1.01 - 1.63；P = 0.04）。
这项荟萃分析表明，与DD-SLT相比，LDLT具有更好的移植物生存率和总生存率。
