Are short-term complications associated with poor allograft and patient survival after liver transplantation? A systematic review of the literature and expert panel recommendations

the ERAS4OLT.org Working Group: Claus Niemann, San Francisco, CA, USA, Joerg-Matthias Pollok, London, UK, Marina Berenguer, Valencia, Spain, Shahi Abdul Ghani, London, UK and Ka Siu Fan, London, UK

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Maximizing patient and allograft survival after liver transplant (LT) is important from both a patient care and organ utilization perspective. Although individual studies have addressed the effects of short-term post-LT complications on a limited scale, there has not been a systematic review of the literature formally assessing the potential effects of early complications on long-term outcomes. Objectives: To identify whether short-term complications after LT affect allograft and overall survival, to identify short-term complications of particular clinical interest and significance, and to provide recommendations to improve post-LT graft and patient survival. Data sources: Ovid MEDLINE, Embase, Scopus, Google Scholar, and Cochrane Central. Methods: A systematic review following PRISMA guidelines and recommendations using the GRADE approach derived from an international expert panel. Results: The literature review and analysis provided show that short-term complications have a large impact on allograft and patient survival after LT. The complications with the strongest effect on survival are acute kidney injury (AKI), biliary complications, and early allograft dysfunction (EAD). Conclusion: This panel recommends taking measures to reduce the risk and incidence of short-term complications post-LT. Clinicians should pay particular attention to preventing or ameliorating AKI, biliary complications, and EAD (Quality of evidence; Moderate | Grade of Recommendation; Strong).

Original languageEnglish (US)
Article numbere14704
JournalClinical Transplantation
Volume36
Issue number10
DOIs
StatePublished - Oct 2022

Keywords

  • allograft survival
  • complications
  • liver transplantation
  • morbidity
  • patient survival
  • recipient survival
  • short-term outcomes

ASJC Scopus subject areas

  • Transplantation

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