Consequences of Cold-Ischemia Time on Primary Nonfunction and Patient and Graft Survival in Liver Transplantation: A Meta-Analysis

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Consequences of Cold-Ischemia Time on Primary Nonfunction and Patient and Graft Survival in Liver Transplantation: A Meta-Analysis

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Title: Consequences of Cold-Ischemia Time on Primary Nonfunction and Patient and Graft Survival in Liver Transplantation: A Meta-Analysis
Author: Kreke, Jennifer E.; Malek, Fawaz Ali Abdul; Schaefer, Andrew J.; Stahl, James E.; Vacanti, Joseph Philip

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Citation: Stahl, James E., Jennifer E. Kreke, Fawaz Ali Abdul Malek, Andrew J. Schaefer, and Joseph Vacanti. 2008. Consequences of cold-ischemia time on primary nonfunction and patient and graft survival in liver transplantation: A meta-analysis. PLoS ONE 3(6): e2468.
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Abstract: Introduction: The ability to preserve organs prior to transplant is essential to the organ allocation process. Objective: The purpose of this study is to describe the functional relationship between cold-ischemia time (CIT) and primary nonfunction (PNF), patient and graft survival in liver transplant. Methods: To identify relevant articles Medline, EMBASE and the Cochrane database, including the non-English literature identified in these databases, was searched from 1966 to April 2008. Two independent reviewers screened and extracted the data. CIT was analyzed both as a continuous variable and stratified by clinically relevant intervals. Nondichotomous variables were weighted by sample size. Percent variables were weighted by the inverse of the binomial variance. Results: Twenty-six studies met criteria. Functionally, PNF% =26.678281+0.9134701*CIT Mean+0.1250879*(CIT Mean29.89535)^220.0067663*(CIT Mean29.89535)^3, r2 = .625, , p,.0001. Mean patient survival: 93 % (1 month), 88 % (3 months), 83 % (6 months) and 83 % (12 months). Mean graft survival: 85.9 % (1 month), 80.5 % (3 months), 78.1 % (6 months) and 76.8 % (12 months). Maximum patient and graft survival occurred with CITs between 7.5–12.5 hrs at each survival interval. PNF was also significantly correlated with ICU time, % first time grafts and % immunologic mismatches. Conclusion: The results of this work imply that CIT may be the most important pre-transplant information needed in the decision to accept an organ.
Published Version: doi://10.1371/journal.pone.0002468
Other Sources: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2430537/pdf/
Terms of Use: This article is made available under the terms and conditions applicable to Other Posted Material, as set forth at http://nrs.harvard.edu/urn-3:HUL.InstRepos:dash.current.terms-of-use#LAA
Citable link to this page: http://nrs.harvard.edu/urn-3:HUL.InstRepos:10219391
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