Yang Ying, He Yu-Cheng, Cai Yun-Shi, Lv Ying-Hao, Liu Chang, Wu Hong
Department of General Surgery, West China Hospital, Sichuan University, Chengdu 610041, China.
Liver Transplant Center, Transplant Center, West China Hospital, Sichuan University, Chengdu 610041, China.
J Clin Med. 2025 Apr 28;14(9):3047. doi: 10.3390/jcm14093047.
: Living donor liver transplantation (LDLT) has become a widely accepted alternative to deceased donor liver transplantation (DDLT). Nevertheless, the available meta-analyses shed light on a perplexing issue regarding which transplant is better. Therefore, we performed an umbrella review to summarize and evaluate the evidence from current meta-analyses. : Two independent reviewers conducted a search of PubMed, Embase, Web of Science, and the Cochrane Database of Systematic Reviews from inception to 1 June 2024. The methodological quality of each included meta-analysis was evaluated using AMSTAR2 (A Measurement Tool to Assess Systematic Reviews). : The search identified 10 meta-analyses from 486 individual articles, including cohort studies and observational studies. Regrettably, the quality of these meta-analyses ranged from critically low to moderate. Receipt of LDLT offers a survival advantage to the patients with HCC compared with DDLT but with a higher complication rate. However, high-quality studies are required in the future to validate our assertions owing to the low certainty of the evidence. : Despite the complication risks, LDLT remains a cost-effective option without compromising patient and graft survival, especially for HCC patients. Extensive, well-designed studies are essential to validate these conclusions.
活体供肝肝移植（LDLT）已成为尸体供肝肝移植（DDLT）广泛接受的替代方案。然而，现有的荟萃分析揭示了一个关于哪种移植更好的令人困惑的问题。因此，我们进行了一项综述，以总结和评估当前荟萃分析的证据。
两名独立审稿人对PubMed、Embase、Web of Science和Cochrane系统评价数据库进行了检索，检索时间从建库至2024年6月1日。使用AMSTAR2（一种评估系统评价的测量工具）对每项纳入的荟萃分析的方法学质量进行评估。
检索从486篇个体文章中确定了10项荟萃分析，包括队列研究和观察性研究。遗憾的是，这些荟萃分析的质量从极低到中等不等。与DDLT相比，接受LDLT的肝癌患者具有生存优势，但并发症发生率更高。然而，由于证据的确定性较低，未来需要高质量的研究来验证我们的断言。
尽管存在并发症风险，但LDLT仍然是一种具有成本效益的选择，在不影响患者和移植物存活的情况下，特别是对于肝癌患者。广泛、设计良好的研究对于验证这些结论至关重要。
