Consequences of cold-ischemia time on primary nonfunction and patient and graft survival in liver transplantation: A meta-analysis

Stahl, JE and Kreke, JE and Abdul Malek, FA and Schaefer, AJ and Vacanti, J (2008) Consequences of cold-ischemia time on primary nonfunction and patient and graft survival in liver transplantation: A meta-analysis. PLoS ONE, 3 (6).

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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%=-6.678281+0.9134701*CIT Mean+0.1250879*(CIT Mean-9.89535) 2 - 0.0067663*(CIT Mean-9.89535) 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. © 2008 Stahl et al.

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Details

Item Type:	Article
Status:	Published
Creators/Authors:	Creators Email Pitt Username ORCID Stahl, JE Kreke, JE Abdul Malek, FA Schaefer, AJ schaefer@pitt.edu SCHAEFER Vacanti, J
Contributors:	Contribution Contributors Name Email Pitt Username ORCID Editor Timmer, Antje UNSPECIFIED UNSPECIFIED UNSPECIFIED
Date:	25 June 2008
Date Type:	Publication
Journal or Publication Title:	PLoS ONE
Volume:	3
Number:	6
DOI or Unique Handle:	10.1371/journal.pone.0002468
Schools and Programs:	Swanson School of Engineering > Industrial Engineering
Refereed:	Yes
PubMed ID:	18575623
Date Deposited:	18 Jul 2012 20:27
Last Modified:	02 Feb 2019 15:55
URI:	http://d-scholarship.pitt.edu/id/eprint/12980

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