The Effects of Volatile Anesthetics on Early Clinical Outcomes in Liver Transplantation: A Systematic Review and Meta-Analysis.

Transplantation proceedings Pub Date : 2024-11-01 Epub Date: 2024-10-29 DOI:10.1016/j.transproceed.2024.09.003

Insun Park, Eun-Ki Min, Jae Hyon Park, Ah-Young Oh, Jung-Hee Ryu

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Abstract

Background: The aim of this systematic review and meta-analysis was to evaluate the effects of volatile anesthesia (VA) on early clinical outcomes in liver transplantation.

Methods: We searched electronic databases to identify relevant studies comparing VA to non-VA in liver transplant recipients. The primary outcome assessed was early allograft dysfunction (EAD), and secondary outcomes were postoperative peak liver function tests (LFT) including aspartate transaminase (AST) and alanine transaminase (ALT) levels, and hospitalization time.

Results: Six relevant studies involving 919 patients were analyzed. In meta-analysis of prospective studies, VA was associated with fewer incidence of EAD than non-VA (RR: 0.45; 95% CI: 0.25, 0.84; P = .012; I² = 0%; P_h = 0.334) but this association was not significant in meta-analysis of retrospective studies (OR: 0.83; 95% CI: 0.58, 1.19; P = .310; I² = 0%; P_h = 0.624). No significant difference in peak AST (SMD: -0.14 U/L; 95% CI: -0.65, 0.37 U/L; P = .594; I² = 69.9%; P_h = 0.036) and ALT (SMD: -0.16 U/L; 95% CI: -0.65, 0.33 U/L; P = .529; I² = 67.0%; P_h = 0.048) were found between VA and non-VA. The hospitalization time also did not differ between the two groups (SMD: -0.09 days; 95% CI: -0.29, 0.10 days; P = .350; I² = 0%; P_h = 0.864).

Conclusions: While there is potential protective effect of VA against EAD in liver transplant recipients, certainty remains low, whereas VA was not associated with postoperative LFT or hospitalization time.

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挥发性麻醉剂对肝移植早期临床结果的影响：系统回顾与元分析》。

背景：本系统综述和荟萃分析旨在评估挥发性麻醉（VA）对肝移植早期临床结果的影响：本系统综述和荟萃分析旨在评估挥发性麻醉（VA）对肝移植早期临床结果的影响：我们对电子数据库进行了检索，以确定在肝移植受者中将挥发性麻醉与非挥发性麻醉进行比较的相关研究。评估的主要结果是早期移植物功能障碍（EAD），次要结果是术后肝功能检测（LFT）峰值，包括天冬氨酸转氨酶（AST）和丙氨酸转氨酶（ALT）水平以及住院时间：对涉及 919 名患者的六项相关研究进行了分析。在前瞻性研究的荟萃分析中，与非前瞻性研究相比，VA与较少的EAD发病率相关（RR：0.45；95% CI：0.25，0.84；P = .012；I2 = 0%；Ph = 0.334），但在回顾性研究的荟萃分析中，这种相关性并不显著（OR：0.83；95% CI：0.58，1.19；P = .310；I2 = 0%；Ph = 0.624）。VA 和非 VA 之间的 AST 峰值（SMD：-0.14 U/L；95% CI：-0.65, 0.37 U/L；P = .594；I2 = 69.9%；Ph = 0.036）和 ALT 峰值（SMD：-0.16 U/L；95% CI：-0.65, 0.33 U/L；P = .529；I2 = 67.0%；Ph = 0.048）无明显差异。两组的住院时间也没有差异（SMD：-0.09 天；95% CI：-0.29，0.10 天；P = .350；I2 = 0%；Ph = 0.864）：虽然VA对肝移植受者的EAD有潜在的保护作用，但确定性仍然很低，而VA与术后LFT或住院时间无关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Transplantation proceedings

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