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01-12-2016 | Original Scientific Report

Temporary Intraoperative Porto-Caval Shunts in Piggy-Back Liver Transplantation Reduce Intraoperative Blood Loss and Improve Postoperative Transaminases and Renal Function: A Meta-Analysis

Authors: Sebastian Pratschke, Alexandra Rauch, Markus Albertsmeier, Markus Rentsch, Michaela Kirschneck, Joachim Andrassy, Michael Thomas, Werner Hartwig, Joan Figueras, Juan Del Rio Martin, Nicola De Ruvo, Jens Werner, Markus Guba, Maximilian Weniger, Martin K. Angele

Published in: World Journal of Surgery | Issue 12/2016

Abstract

Background

The value of temporary intraoperative porto-caval shunts (TPCS) in cava-sparing liver transplantation is discussed controversially. Aim of this meta-analysis was to analyze the impact of temporary intraoperative porto-caval shunts on liver injury, primary non-function, time of surgery, transfusion of blood products and length of hospital stay in cava-sparing liver transplantation.

Methods

A systematic search of MEDLINE/PubMed, EMBASE and PsycINFO retrieved a total of 909 articles, of which six articles were included. The combined effect size and 95 % confidence interval were calculated for each outcome by applying the inverse variance weighting method. Tests for heterogeneity (I ²) were also utilized.

Results

Usage of a TPCS was associated with significantly decreased AST values, significantly fewer transfusions of packed red blood cells and improved postoperative renal function. There were no statistically significant differences in primary graft non-function, length of hospital stay or duration of surgery.

Conclusion

This meta-analysis found that temporary intraoperative porto-caval shunts in cava-sparing liver transplantation reduce blood loss as well as hepatic injury and enhance postoperative renal function without prolonging operative time. Randomized controlled trials investigating the use of temporary intraoperative porto-caval shunts are needed to confirm these findings.

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Title: Temporary Intraoperative Porto-Caval Shunts in Piggy-Back Liver Transplantation Reduce Intraoperative Blood Loss and Improve Postoperative Transaminases and Renal Function: A Meta-Analysis
Authors: Sebastian Pratschke
Alexandra Rauch
Markus Albertsmeier
Markus Rentsch
Michaela Kirschneck
Joachim Andrassy
Michael Thomas
Werner Hartwig
Joan Figueras
Juan Del Rio Martin
Nicola De Ruvo
Jens Werner
Markus Guba
Maximilian Weniger
Martin K. Angele
Publication date: 01-12-2016
Publisher: Springer International Publishing
Published in: World Journal of Surgery / Issue 12/2016
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-016-3656-1

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Temporary Intraoperative Porto-Caval Shunts in Piggy-Back Liver Transplantation Reduce Intraoperative Blood Loss and Improve Postoperative Transaminases and Renal Function: A Meta-Analysis

Abstract

Background

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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