Published online Jul 27, 2023. doi: 10.4240/wjgs.v15.i7.1522
Peer-review started: November 25, 2022
First decision: February 20, 2023
Revised: February 22, 2023
Accepted: March 27, 2023
Article in press: March 27, 2023
Published online: July 27, 2023
Processing time: 238 Days and 13.6 Hours
The outcomes of liver transplantation (LT) from different grafts have been studied individually and in combination, but the reports were conflicting with some researchers finding no difference in both short-term and long-term outcomes between the deceased donor split LT (DD-SLT) and living donor LT (LDLT).
To compare the outcomes of DD-SLT and LDLT we performed this systematic review and meta-analysis.
This systematic review was performed in compliance with the Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines. The following databases were searched for articles comparing outcomes of DD-SLT and LDLT: PubMed; Google Scholar; Embase; Cochrane Central Register of Controlled Trials; the Cochrane Database of Systematic Reviews; and Reference Citation Analysis (https://www.referencecitationanalysis.com/). The search terms used were: “liver transplantation;” “liver transplant;” “split liver transplant;” “living donor liver transplant;” “partial liver transplant;” “partial liver graft;” “ex vivo splitting;” and “in vivo splitting.”
Ten studies were included for the data synthesis and meta-analysis. There were a total of 4836 patients. The overall survival rate at 1 year, 3 years and 5 years was superior in patients that received LDLT compared to DD-SLT. At 1 year, the hazard ratios was 1.44 (95% confidence interval: 1.16-1.78; P = 0.001). The graft survival rate at 3 years and 5 years was superior in the LDLT group (3 year hazard ratio: 1.28; 95% confidence interval: 1.01-1.63; P = 0.04).
This meta-analysis showed that LDLT has better graft survival and overall survival when compared to DD-SLT.
Core Tip: This meta-analysis is one of the few studies in the literature to compare the deceased donor split liver transplantation (DD-SLT) and living donor liver transplantation (LDLT) patients in terms of clinical outcomes. Although this study had some limitations, this meta-analysis showed that LDLT has better graft survival and overall survival compared to DD-SLT. The allograft in LDLT also had superior outcomes compared to DD-SLT in terms of acute rejection.