Transplantation Reviews最新文献

{"title":"Recurrent complement-mediated Hemolytic uremic syndrome after kidney transplantation","authors":"Shota Obata ,&nbsp;Frank Hullekes ,&nbsp;Leonardo V. Riella ,&nbsp;Paolo Cravedi","doi":"10.1016/j.trre.2024.100857","DOIUrl":"10.1016/j.trre.2024.100857","url":null,"abstract":"<div><p>Hereditary forms of <em>hemolytic uremic syndrome</em> (HUS), formerly known as atypical HUS, typically involve mutations in genes encoding for components of the alternative pathway of complement, therefore they are often referred to as complement-mediated HUS (cHUS). This condition has a high risk of recurrence in the transplanted kidney, leading to accelerated graft loss. The availability of anti-complement component C5 antibody eculizumab has enabled successful transplantation with a notably reduced recurrence rate and improved prognosis. Open questions are related to the potential for complement inhibitor discontinuation, ideal timing of treatment withdrawal, and patient selection based on genetic abnormalities. Our review delves into the pathophysiology, classification, genetic predispositions, and management strategies for cHUS in the native and transplant kidneys.</p></div>","PeriodicalId":48973,"journal":{"name":"Transplantation Reviews","volume":"38 3","pages":"Article 100857"},"PeriodicalIF":4.0,"publicationDate":"2024-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140946788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Experiences of living kidney donors: A synthesis of unsolicited patient narratives","authors":"Katya Loban ,&nbsp;Saly El Wazze ,&nbsp;Théa Milland ,&nbsp;Lindsay Hales ,&nbsp;Anita Slominska ,&nbsp;Shaifali Sandal","doi":"10.1016/j.trre.2024.100855","DOIUrl":"https://doi.org/10.1016/j.trre.2024.100855","url":null,"abstract":"<div><h3>Introduction</h3><p>Despite the lauded benefits of living kidney donation, there is growing evidence of the challenges that living kidney donors (LKD) encounter in their donation trajectory and gaps in healthcare service provision. However, most of the evidence is derived from research conducted by clinicians or academic investigators. Significantly less attention has been devoted to analyzing unsolicited accounts of LKDs' experiences.</p></div><div><h3>Methods</h3><p>We conducted a review and synthesis of published unsolicited first-person narratives of LKDs and aimed to synthesize their experiences and identify care needs. Four electronic databases were searched and 27 LKD narratives were included in our final analysis. Thematic synthesis was used to generate themes inductively.</p></div><div><h3>Results</h3><p>Although the majority of LKDs reported the act of donation to be a fulfilling experience, almost 48% reported encountering challenges in the care that they received. Also, 29% of LKDs reported experiencing an adverse clinical event. Five distinct themes emerged surrounding the donation experience and healthcare needs: 1) Educational needs due to perceived lack of transparency and compensating for knowledge gaps; 2) Respect for donor autonomy due to coercive influences from family or healthcare providers, lack of respect for donor preferences and loopholes in the consent process; 3) Unmet care needs related to poor communication with healthcare providers, coordination issues and inconsistent and inadequate long-term care; 4) Unanticipated outcomes due to economic costs and the emotional burden of donation; and 5) Contributing beyond the donation event by advocating for a balanced view of donation and generating support mechanisms.</p></div><div><h3>Conclusion</h3><p>In this synthesis of LKDs narratives, important care gaps and the need to advocate for a balanced perspective on living kidney donation were highlighted. Our review underscores the value of patients' own stories as critical evidence that can inform improvement in healthcare service delivery.</p></div>","PeriodicalId":48973,"journal":{"name":"Transplantation Reviews","volume":"38 3","pages":"Article 100855"},"PeriodicalIF":4.0,"publicationDate":"2024-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0955470X24000387/pdfft?md5=355654ade176fce81810810b337fcaf3&pid=1-s2.0-S0955470X24000387-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140637857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diet and physical activity interventions to improve cardiovascular disease risk factors in liver transplant recipients: Systematic review and meta-analysis","authors":"Lynsey N. Spillman ,&nbsp;Emily Stowe ,&nbsp;Angela M. Madden ,&nbsp;Kirsten L. Rennie ,&nbsp;Linda M. Oude Griep ,&nbsp;Michael Allison ,&nbsp;Leia Kenney ,&nbsp;Ciara O'Connor ,&nbsp;Simon J. Griffin","doi":"10.1016/j.trre.2024.100852","DOIUrl":"https://doi.org/10.1016/j.trre.2024.100852","url":null,"abstract":"<div><h3>Background and aims</h3><p>Cardiovascular disease, associated risk factors and obesity are prevalent after liver transplant and modifiable through lifestyle changes. Understanding what lifestyle interventions and their respective components are effective is essential for translation to clinical practice. We aimed to investigate the effects of diet and physical activity interventions on weight, body mass index and other cardiovascular disease risk factors in liver transplant recipients, and systematically describe the interventions.</p></div><div><h3>Methods</h3><p>We systematically searched Embase, MEDLINE, Psycho Info, CINAHL, Cochrane central register of controlled trials, PeDro, AMED, BNI, Web of Science, OpenGrey, <span>ClinicalTrials.gov</span><svg><path></path></svg> and the international clinical trials registry from inception to 31 May 2023. Search results were screened by two independent reviewers: randomised control trials with interventions that targeted diet and physical activity behaviours in liver transplant recipients were considered eligible. Two independent reviewers extracted and synthesised data for study, participant and intervention details and results. We used the Revised Cochrane Risk of Bias Tool for Randomised Trials to assess risk of bias for outcomes and the GRADE approach to rate the quality of the body of evidence. When two or more studies reported findings for an outcome, we pooled data using random-effects meta-analysis.</p></div><div><h3>Results</h3><p>Six studies were included, reporting three physical activity and three combined diet and physical activity interventions. Participants were 2 months-4 years post-transplant. Interventions lasted 12 weeks-10 months and were delivered remotely and/or in-person, most commonly delivered to individual participants by health care or sports professionals. Five studies described individual tailoring, e.g. exercise intensity. Adherence to interventions ranged from 51% to 94%. No studies reported fidelity. Intervention components were not consistently reported. In meta-analysis, diet and physical activity interventions did not significantly reduce weight or body mass index compared to control groups, however no studies targeted participants with obesity. Diet and physical activity interventions reduced percentage body fat and triglycerides compared to control groups but did not reduce total cholesterol or increase activity. The GRADE quality of evidence was low or very low.</p></div><div><h3>Conclusion</h3><p>Diet and physical activity interventions reduced percentage body fat and triglycerides in liver transplant recipients. Further good quality research is needed to evaluate their effect on other cardiovascular disease risk factors, including weight and BMI. Interventions need to be better described and evaluated to improve evidence base and inform patient care.</p></div>","PeriodicalId":48973,"journal":{"name":"Transplantation Reviews","volume":"38 3","pages":"Article 100852"},"PeriodicalIF":4.0,"publicationDate":"2024-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0955470X24000351/pdfft?md5=84af9ad5e2279d500f4a54e0f7f8e0bc&pid=1-s2.0-S0955470X24000351-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140548534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of donor smoking history on kidney transplant recipient outcomes: A systematic review and meta-analysis","authors":"Christie Rampersad ,&nbsp;Jason Bau ,&nbsp;Ani Orchanian-Cheff ,&nbsp;S. Joseph Kim","doi":"10.1016/j.trre.2024.100854","DOIUrl":"https://doi.org/10.1016/j.trre.2024.100854","url":null,"abstract":"<div><h3>Background</h3><p>Impact of donor smoking history on kidney transplant recipient outcomes is undefined.</p></div><div><h3>Methods</h3><p>We systematically searched, critically appraised, and summarized associations between donor smoking and primary outcomes of death-censored and all-cause graft failure (DCGF, ACGF), and secondary outcomes of allograft histology, delayed graft function, serum creatinine, estimated glomerular filtration rate, and mortality. We searched MEDLINE, Embase, and Cochrane Databases from 2000 to 2023. Risk of bias was assessed using Risk of Bias in Non-randomized Studies – of Exposure tool. Quality of evidence was assessed by Grading of Recommendations Assessment, Development and Evaluation Working Group recommendations. We pooled results using inverse variance, random-effects model and reported hazard ratios for time-to-event outcomes or binomial proportions. Statistical heterogeneity was assessed with I² statistic.</p></div><div><h3>Results</h3><p>From 1785 citations, we included 17 studies. Donor smoking was associated with modestly increased DCGF (HR 1.05 (95% CI: 1.01, 1.09); I² = 0%; low quality of evidence), predominantly in deceased donors, and ACGF in adjusted analyses (HR 1.12 (95% CI: 1.06, 1.19); I² = 20%; very low quality of evidence). Other outcomes could not be pooled meaningfully.</p></div><div><h3>Conclusions</h3><p>Kidney donor smoking history was associated with modestly increased risk of death-censored graft failure and all-cause graft failure. This review emphasizes the need for further research, standardized reporting, and thoughtful consideration of donor factors like smoking in clinical decision-making on kidney utilization and allocation.</p></div>","PeriodicalId":48973,"journal":{"name":"Transplantation Reviews","volume":"38 3","pages":"Article 100854"},"PeriodicalIF":4.0,"publicationDate":"2024-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0955470X24000375/pdfft?md5=5f92359369b9f0a731b3f70e9d0069e9&pid=1-s2.0-S0955470X24000375-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140543030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Return of the cold: How hypothermic oxygenated machine perfusion is changing liver transplantation","authors":"Charles W.G. Risbey ,&nbsp;Ngee-Soon Lau ,&nbsp;Anita Niu ,&nbsp;Wesley B. Zhang ,&nbsp;Michael Crawford ,&nbsp;Carlo Pulitano","doi":"10.1016/j.trre.2024.100853","DOIUrl":"https://doi.org/10.1016/j.trre.2024.100853","url":null,"abstract":"<div><p>Hypothermic Oxygenated machine PErfusion (HOPE) has recently emerged as a preservation technique which can reduce ischemic injury and improve clinical outcomes following liver transplantation. First developed with the advent solid organ transplantation techniques, hypothermic machine perfusion largely fell out of favour following the development of preservation solutions which can satisfactorily preserve grafts using the cheap and simple method, static cold storage (SCS). However, with an increasing need to develop techniques to reduce graft injury and better utilise marginal and donation after circulatory death (DCD) grafts, HOPE has emerged as a relatively simple and safe technique to optimise clinical outcomes following liver transplantation. Perfusing the graft with cold, acellular, oxygenated perfusate either via the portal vein (PV) alone, or via both the PV and hepatic artery (HA), HOPE is generally commenced for a period of 1–2 h immediately prior to implantation. The technique has been validated by multiple randomised control trials, and pre-clinical evidence suggests HOPE primarily reduces graft injury by decreasing the accumulation of harmful mitochondrial intermediates, and subsequently, the severity of post-reperfusion injury. HOPE can also facilitate real time graft assessment, most notably via the measurement of flavin mononucleotide (FMN) in the perfusate, allowing transplant teams to make better informed clinical decisions prior to transplantation. HOPE may also provide a platform to administer novel therapeutic agents to ex situ organs without risk of systemic side effects. As such, HOPE is uniquely positioned to revolutionise how liver transplantation is approached and facilitate optimised clinical outcomes for liver transplant recipients.</p></div>","PeriodicalId":48973,"journal":{"name":"Transplantation Reviews","volume":"38 3","pages":"Article 100853"},"PeriodicalIF":4.0,"publicationDate":"2024-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140533570","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to “Post-transplant lymphoproliferative disorders following kidney transplantation: A literature review with updates on risk factors, prognostic indices, screening strategies, treatment and analysis of donor type” [Transplantation Reviews 2024; 38(2):100837]","authors":"Mehmet Ergisi ,&nbsp;Bryan Ooi ,&nbsp;Omar Salim ,&nbsp;Vassilios Papalois","doi":"10.1016/j.trre.2024.100843","DOIUrl":"10.1016/j.trre.2024.100843","url":null,"abstract":"","PeriodicalId":48973,"journal":{"name":"Transplantation Reviews","volume":"38 2","pages":"Article 100843"},"PeriodicalIF":4.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0955470X24000260/pdfft?md5=94e82e19d92e8961be7a9cd725e93fa6&pid=1-s2.0-S0955470X24000260-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140308470","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tacrolimus intra-patient variability measures and its associations with allograft clinical outcomes in kidney transplantation","authors":"Wenmin Xie ,&nbsp;Shupan Fan ,&nbsp;Ruolin Liu ,&nbsp;Wencheng Yan ,&nbsp;Chengxin Su ,&nbsp;Kaile Zheng ,&nbsp;Xuebin Wang ,&nbsp;Zhuo Wang","doi":"10.1016/j.trre.2024.100842","DOIUrl":"10.1016/j.trre.2024.100842","url":null,"abstract":"<div><h3>Aims</h3><p>Tacrolimus (Tac) is commonly prescribed in solid organ transplantation to prevent immune-mediated damage to the graft. However, its pharmacokinetics show substantial variability between and within patients. Intra-patient variability of tacrolimus (Tac-IPV) has emerged as a novel marker to predict transplant outcomes. Numerous studies report varying associations between Tac-IPV and clinical outcomes, with Tac-IPV measures showing wide discrepancies among these studies. This inconsistency could be a significant factor that influences the various outcomes reported in different studies. Our review comprehensively assesses the relationship between various Tac-IPV measures and their associations with clinical outcomes in transplant patients.</p></div><div><h3>Methods</h3><p>A comprehensive literature search was conducted using the PubMed and Embase databases, covering the period from 2004 to March 31, 2023. The search focused on studies that examined the relationship between Tac-IPV and clinical outcomes in kidney transplantation (KT). The inclusion criteria were specific to studies addressing Tac-IPV, including measures such as standard deviation (SD), coefficient of variation (CV), time-weighted coefficient of variability (CV), mean absolute deviation (MAD), and Tac variability score (TVS). Clinical outcomes included the development of de novo donor-specific antibodies (dnDSA), rejection episodes, graft loss, and graft failure.</p></div><div><h3>Results</h3><p>Among the 33 studies that met the inclusion criteria, a notable proportion presented conflicting findings in their assessment of various Tac-IPV measures regarding dnDSA, rejection episodes, graft loss, and graft failure.</p></div><div><h3>Conclusions</h3><p>Most studies have identified a correlation between high Tac-IPV and poor clinical outcomes; however, this relationship is multifactorial. Influencing factors include the metabolic status of KT patients, the timing of Tac-IPV calculations, and the criteria for defining high and low Tac-IPV thresholds, including the size and selection method. CV, MAD, and TWCV are the metrics that are most frequently used to determine Tac-IPV. Additionally, most of the methods for establishing Tac-IPV thresholds typically employ receiver operating characteristic (ROC) curves and median values. It is also notable that studies examining the clinical significance of Tac-IPV often include tacrolimus levels measured six months after kidney transplantation.</p></div>","PeriodicalId":48973,"journal":{"name":"Transplantation Reviews","volume":"38 3","pages":"Article 100842"},"PeriodicalIF":4.0,"publicationDate":"2024-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140280005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Research progress on anatomy reconstruction of rat orthotopic liver transplantation","authors":"Weikang Wu ,&nbsp;Juzheng Yuan ,&nbsp;Fuyuan Liu ,&nbsp;Lu Liu ,&nbsp;Xudan Wang ,&nbsp;Xiao Li ,&nbsp;Kaishan Tao","doi":"10.1016/j.trre.2024.100841","DOIUrl":"https://doi.org/10.1016/j.trre.2024.100841","url":null,"abstract":"<div><p>Rat orthotopic liver transplantation (ROLT) serves as an ideal animal model and has gained popularity in addressing complications and perioperative treatments related to clinical liver transplantation. Through extensive research on ROLT model construction, the conventional “two-cuff” method has gradually become established. However, traditional methods still present challenges including limited visual field during vascular suturing, vascular torsion, biliary tract injuries, and prolonged anhepatic periods. Consequently, this paper aims to review the latest advancements and various techniques in this field, providing a valuable reference for individuals interested in constructing ROLT models.</p></div>","PeriodicalId":48973,"journal":{"name":"Transplantation Reviews","volume":"38 2","pages":"Article 100841"},"PeriodicalIF":4.0,"publicationDate":"2024-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140187191","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Was antiviral prophylaxis necessary after kidney transplantation utilizing HBcAb+ donors? A systematic review and meta-analysis","authors":"Saifu Yin ,&nbsp;Xiaoting Chen ,&nbsp;Xingxing Li ,&nbsp;Fan Zhang ,&nbsp;Jiapei Wu ,&nbsp;Tao Lin","doi":"10.1016/j.trre.2024.100840","DOIUrl":"https://doi.org/10.1016/j.trre.2024.100840","url":null,"abstract":"<div><h3>Background</h3><p>Current guidelines lack consensus on whether antiviral prophylaxes should be administered after kidney transplantation from HBcAb+ donors. This systematic review and meta-analysis aimed to evaluate the incidence and risk factors of de novo HBV (DNH) infection, as well as graft and patient survival.</p></div><div><h3>Methods</h3><p>We searched PubMed, Embase, and the Cochrane Library up to December 31, 2023. We included relevant studies that assessed clinical outcomes following transplantation utilizing HBcAb+ kidneys. Summary measures of effect and 95% confidence intervals (CI) for prevalence, risk factors, as well as graft and patient survival were estimated using random-effects meta-analysis.</p></div><div><h3>Results</h3><p>Thirteen studies were included for the final analysis. The DNH incidence was at 0.36% (9/2516) with low heterogeneity (I² = 6%). HBsAb+ recipients (OR: 0.78, 95%CI: 0.25–2.38), HBcAb+ recipients (OR: 3.11, 95%CI: 0.91–10.66, <em>P</em> = 0.071), and recipients not receiving any antiviral prophylaxis (OR: 1.26, 95%CI: 0.15–10.58) were not associated with higher DNH risk. Specifically, HBsAb-/HBcAb+ recipients had the highest DNH incidence (4.65%), followed by HBsAb-/HBcAb- (0.49%), HBsAb+/HBcAb- recipients (0.45%), and HBsAb+/HBcAb+ (0%). Furthermore, recipients receiving HBcAb+ kidneys had comparable graft survival (HR: 1.06, 95%CI: 0.94–1.19, <em>P</em> = 0.55) and patient survival (HR:1.16, 95%CI: 0.98–1.38, <em>P</em> = 0.090) compared with recipients receiving HBcAb- kidneys.</p></div><div><h3>Conclusion</h3><p>Kidney transplantation utilizing HBcAb+ kidneys contributed to comparable graft and patient survival with an extremely low risk of HBV transmission. Antiviral prophylaxes may only be administered in HBsAb-/HBcAb+ recipients.</p></div>","PeriodicalId":48973,"journal":{"name":"Transplantation Reviews","volume":"38 2","pages":"Article 100840"},"PeriodicalIF":4.0,"publicationDate":"2024-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140135130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of echocardiographic assessment for the risk of adverse events in liver transplant recipients: A systematic review and meta-analysis","authors":"Quirino Lai ,&nbsp;Miriam Caimano ,&nbsp;Francesca Canale ,&nbsp;Lucia Ilaria Birtolo ,&nbsp;Flaminia Ferri ,&nbsp;Stefano Ginanni Corradini ,&nbsp;Massimo Mancone ,&nbsp;Giuseppe Marrone ,&nbsp;Daniela Pedicino ,&nbsp;Massimo Rossi ,&nbsp;Elisabetta Vernole ,&nbsp;Maurizio Pompili ,&nbsp;Marco Biolato","doi":"10.1016/j.trre.2024.100838","DOIUrl":"10.1016/j.trre.2024.100838","url":null,"abstract":"<div><h3>Background &amp; Aims</h3><p>Echocardiographic findings may provide valuable information about the cardiac conditions in cirrhotic patients waiting for liver transplantation (LT). However, data on the ability of the different echocardiographic parameters to predict post-transplant risk of mortality are scarce and heterogeneous. This systematic review evaluates the role of different echocardiographic features as predictors of post-LT mortality. A meta-analysis was also performed according to the observed results.</p></div><div><h3>Methods</h3><p>A systematic review was conducted according to PRISMA guidelines. Medline (PubMed) database was searched through February 2023 for relevant published original articles reporting the prognostic value of echocardiographic findings associated with outcomes of adult LT recipients. The risk of bias in included articles was assessed using ROBINS-E tool. Methodological quality varied from low to high across the risk of bias domains.</p></div><div><h3>Results</h3><p>Twenty-three studies were identified after the selection process; ten were enrollable for the meta-analyses. According to the results observed, the E/A ratio fashioned as a continuous value (HR = 0.43, 95%CI = 0.25–0.76; <em>P</em> = 0.003), and tricuspid regurgitation (HR = 2.36, 95%CI = 1.05–5.31; <em>P</em> = 0.04) were relevant predicting variables for post-LT death. Other echocardiographic findings failed to merge with statistical relevance.</p></div><div><h3>Conclusion</h3><p>Tricuspid regurgitation and left ventricular diastolic dysfunction play a role in the prediction of post-LT death. More studies are needed to clarify further the impact of these echocardiographic features in the transplantation setting.</p></div>","PeriodicalId":48973,"journal":{"name":"Transplantation Reviews","volume":"38 2","pages":"Article 100838"},"PeriodicalIF":4.0,"publicationDate":"2024-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139945401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}