TY - JOUR
T1 - Are short-term complications associated with poor allograft and patient survival after liver transplantation? A systematic review of the literature and expert panel recommendations
AU - 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
AU - Alconchel, Felipe
AU - Tinguely, Pascale
AU - Frola, Carlo
AU - Spiro, Michael
AU - Ciria, Ruben
AU - Rodríguez, Gonzalo
AU - Petrowsky, Henrik
AU - Raptis, Dimitri Aristotle
AU - Brombosz, Elizabeth W.
AU - Ghobrial, Mark
N1 - Funding Information:
This manuscript was prepared for the ERAS4OLT.org Consensus Conference 2022, which is partially funded by the International Liver Transplant Society (ILTS).
Publisher Copyright:
© 2022 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
PY - 2022/10
Y1 - 2022/10
N2 - 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).
AB - 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).
KW - allograft survival
KW - complications
KW - liver transplantation
KW - morbidity
KW - patient survival
KW - recipient survival
KW - short-term outcomes
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U2 - 10.1111/ctr.14704
DO - 10.1111/ctr.14704
M3 - Article
C2 - 36490223
AN - SCOPUS:85143917373
VL - 36
JO - Clinical Transplantation
JF - Clinical Transplantation
SN - 0902-0063
IS - 10
M1 - e14704
ER -