{Reference Type}: Journal Article
{Title}: Factors affecting survival after liver retransplantation: a systematic review and meta-analysis.
{Author}: Brombosz EW;Moore LW;Mobley CM;Kodali S;Saharia A;Hobeika MJ;Connor AA;Victor DW;Cheah YL;Simon CJ;Gaber AO;Ghobrial RM;
{Journal}: Front Transplant
{Volume}: 2
{Issue}: 0
{Year}: 2023
暂无{DOI}: 10.3389/frtra.2023.1181770
{Abstract}: <B>UNASSIGNED: </B>Liver retransplantation (reLT) has historically had inferior survival relative to primary liver transplant (LT). To improve outcomes after reLT, researchers have identified factors predicting overall (OS) and/or graft survival (GS) after reLT. This systematic review and random effects meta-analysis sought to summarize this literature to elucidate the strongest independent predictors of post-reLT.<BR><B>UNASSIGNED: </B>A systematic review was conducted to identify manuscripts reporting factors affecting survival in multivariable Cox proportional hazards analyses. Papers with overlapping cohorts were excluded.<BR><B>UNASSIGNED: </B>All 25 included studies were retrospective, and 15 (60%) were single-center studies. Patients on pre-transplant ventilation (HR, 3.11; 95% CI, 1.56-6.20; p = 0.001) and with high serum creatinine (HR, 1.46; 95% CI, 1.15-1.87; p = 0.002) had the highest mortality risk after reLT. Recipient age, Model for End-Stage Liver Disease score, donor age, and cold ischemia time >12 h also conferred a significant risk of post-reLT death (all p < 0.05). Factors affecting GS included donor age and retransplant interval (the time between LT and reLT; both p < 0.05). OS is significantly higher when the retransplant interval is ≤7 days relative to 8-30 days (p = 0.04).<BR><B>UNASSIGNED: </B>The meta-analysis was complicated by papers utilizing non-standardized cut-off values to group variables, which made between-study comparisons difficult. However, it did identify 7 variables that significantly impact survival after reLT, which could stimulate future research into improving post-reLT outcomes.