Combined heart and liver transplantation: an updated systematic review

Introduction Combined heart and liver transplantation (CHLT) is one of the most complex procedures of surgery that has been implemented in the last 35 years. The aim of our meta-analysis was to investigate the safety and efficacy of CHLT. Materials The meta-analysis was designed according to PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) and AMSTAR (A MeaSurement Tool to Assess systematic Reviews) recommendations. A literature search was conducted up to April 2020 using the MEDLINE,® SCOPUS,® ClinicalTrials.gov, Embase™, Cochrane Central Register of Controlled Trials and Google Scholar™ databases. Results Our meta-analysis included 16 studies with 860 patients. The mortality rate following CHLT was 14.1%. One and five-year survival rates were 85.3% and 71.4% while the heart and liver rejection rates were 6.1% and 9.1% respectively. The hospital stay was 25.8 days and the intensive care unit stay was 9.9 days. Pooled values were also calculated for cardiopulmonary bypass duration, units of transfused red blood cells and fresh frozen plasma, postoperative infection rate, mechanical ventilation rate and follow-up duration. Conclusions Despite its complexity, CHLT is a safe and effective procedure for the management of lethal diseases that lead to progressive heart and/or liver failure. Nevertheless, there must be strict adherence to the indications for surgery, and future studies should compare CHLT with isolated cardiac and hepatic transplantations.

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Esophageal defect repair by artificial scaffolds: a systematic review of experimental studies and proportional meta-analysis

Diseases of the Esophagus ◽

10.1093/dote/doaa104 ◽

2020 ◽

Author(s):

Dimitrios Schizas ◽

Maximos Frountzas ◽

Emmanouil Sgouromallis ◽

Eleftherios Spartalis ◽

Konstantinos S Mylonas ◽

...

Keyword(s):

Tissue Engineering ◽

Systematic Reviews ◽

Meta Analysis ◽

Survival Rates ◽

Experimental Studies ◽

Esophageal Replacement ◽

Measurement Tool ◽

Cochrane Central Register ◽

Graft Stenosis ◽

Meta Analyses

Abstract Background The traditional technique of gastrointestinal reconstruction of the esophagus after esophagectomy presents plenty of complications. Hence, tissue engineering has been introduced as an effective artificial alternative with potentially fewer complications. Three types of esophageal scaffolds have been used in experimental studies so far. The aim of our meta-analysis is to present the postoperative outcomes after esophageal replacement with artificial scaffolds and the investigation of possible factors that affect these outcomes. Methods The present proportional meta-analysis was designed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses and A MeaSurement Tool to Assess systematic Reviews guidelines. We searched Medline, Scopus, Clinicaltrials.gov, EMBASE, Cochrane Central Register of Controlled Trials CENTRAL, and Google Scholar databases from inception until February 2020. Results Overall, 32 studies were included that recruited 587 animals. The pooled morbidity after esophageal scaffold implantation was 53.4% (95% CI = 36.6–70.0%). The pooled survival interval was 111.1 days (95% CI = 65.5–156.8 days). Graft stenosis (46%), postoperative dysphagia (15%), and anastomotic leak (12%) were the most common complications after esophageal scaffold implantation. Animals that underwent an implantation of an artificial scaffold in the thoracic part of their esophagus presented higher survival rates than animals that underwent scaffold implantation in the cervical or abdominal part of their esophagus (P < 0.001 and P = 0.011, respectively). Conclusion Tissue engineering seems to offer an effective alternative for the repair of esophageal defects in animal models. Nevertheless, issues like graft stenosis and lack of motility of the esophageal scaffolds need to be addressed in future experimental studies before scaffolds can be tested in human trials.

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Liver Transplantation Without the Use of Fresh Frozen Plasma

Anesthesia & Analgesia ◽

10.1213/00000539-199610000-00004 ◽

1996 ◽

Vol 83 (4) ◽

pp. 681-686 ◽

Cited By ~ 31

Author(s):

Jacques Dupont ◽

Frederic Messiant ◽

Nicole Declerck ◽

Benoit Tavernier ◽

Brigitte Jude ◽

...

Keyword(s):

Liver Transplantation ◽

Fresh Frozen Plasma ◽

Fresh Frozen ◽

Frozen Plasma

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Systematic Reviews and Meta-analysis Published in Indexed Portuguese Medical Journals: Time Trends and Critical Appraisal.

10.21203/rs.3.rs-354547/v1 ◽

2021 ◽

Author(s):

Luísa Prada ◽

Ana Prada ◽

Miguel Antunes ◽

Ricardo Fernandes ◽

João Costa ◽

...

Keyword(s):

Systematic Reviews ◽

Critical Appraisal ◽

Data Extraction ◽

Evidence Synthesis ◽

Meta Analysis ◽

Measurement Tool ◽

Medical Journals ◽

Electronic Search ◽

Potential Impact

Abstract Introduction:Over the last years, the number of systematic reviews published is steadily increasing due to the global interest in this type of evidence synthesis. However, little is known about the characteristics of this research published in Portuguese medical journals. This study aims to evaluate the publication trends and overall quality of these systematic reviews.Material and Methods:Systematic reviews were identified through an electronic search up to August 2020, targeting Portuguese Medical journals indexed in MEDLINE. Systematic reviews selection and data extraction were done independently by three authors. The overall quality critical appraisal using the A MeaSurement Tool to Assess systematic Reviews (AMSTAR II) was independently assessed by three authors. Disagreements were solved by consensus.Results:Seventy systematic reviews published in 5 Portuguese medical journals were included. Most (n=57; 81,4%) were systematic reviews without meta-analysis. Until 2010, the number of systematic reviews per year increased. Since then, the number of reviews published has not remained stable and no less than 3 SRs were published per year. According to the systematic reviews’ typology, most have been predominantly conducted to assess the effectiveness of health interventions (n=28; 40,0%). General and Internal Medicine (n=26; 37,1%) was the most addressed field. Most systematic reviews (n=45; 64,3%) were rated as being of “critically low-quality”.Conclusions:There were consistent flaws in the methodological quality report of the systematic reviews included, particularly in establishing a prior protocol and not assessing the potential impact of the risk of bias on the results.Through the years, the number of systematic reviews published increased, yet their quality is suboptimal. There is a need to improve the reporting of systematic reviews in Portuguese medical journals, which can be achieved by better adherence to quality checklists/tools.Systematic review registration: INPLASY202090105

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Prothrombin Complex Concentrates are Superior to Fresh Frozen Plasma for Emergency Reversal of Vitamin K Antagonists: A Meta-Analysis in 2606 Subjects

Drugs ◽

10.1007/s40265-019-01179-w ◽

2019 ◽

Vol 79 (14) ◽

pp. 1557-1565 ◽

Cited By ~ 1

Author(s):

Robert Hill ◽

Thang S. Han ◽

Irina Lubomirova ◽

Nikhil Math ◽

Paul Bentley ◽

...

Keyword(s):

Vitamin K ◽

Meta Analysis ◽

Vitamin K Antagonists ◽

Fresh Frozen Plasma ◽

Prothrombin Complex Concentrates ◽

Fresh Frozen ◽

Frozen Plasma

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A Randomized Trial of Solvent/Detergent and Standard Fresh Frozen Plasma in the Treatment of the Coagulopathy seen during Orthotopic Liver Transplantation

Vox Sanguinis ◽

10.1111/j.1423-0410.1998.tb05477.x ◽

1998 ◽

Vol 74 (S1) ◽

pp. 225-229 ◽

Cited By ~ 18

Author(s):

J. W. Freeman ◽

L. M. Williamson ◽

C. Llewelyn ◽

N. Fisher ◽

J. P. Allain ◽

...

Keyword(s):

Liver Transplantation ◽

Randomized Trial ◽

Orthotopic Liver Transplantation ◽

Fresh Frozen Plasma ◽

Fresh Frozen ◽

Frozen Plasma

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Safety and Efficacy in Relapsed or Refractory Classic Hodgkin’s Lymphoma Treated with PD-1 Inhibitors: A Meta-Analysis of 9 Prospective Clinical Trials

BioMed Research International ◽

10.1155/2019/9283860 ◽

2019 ◽

Vol 2019 ◽

pp. 1-13 ◽

Cited By ~ 1

Author(s):

Xueyan Zhang ◽

Li Chen ◽

Yawei Zhao ◽

Huiru Yin ◽

He Ma ◽

...

Keyword(s):

Clinical Trials ◽

Immune Checkpoint ◽

Hodgkin’S Lymphoma ◽

Checkpoint Inhibitors ◽

Meta Analysis ◽

Survival Rates ◽

Hodgkin's Lymphoma ◽

Controlled Trials ◽

Cochrane Central Register ◽

Safety And Efficacy

Background. Classic Hodgkin’s lymphoma (cHL) is characterized by the unique biology in which rare Hodgkin-Reed-Sternberg cells propagate an immunosuppressive microenvironment. Checkpoint inhibitors that target the interaction of PD-1 immune checkpoint receptors have demonstrated remarkable activities in various cancers, such as cHL. This study aims to evaluate the safety and efficacy of PD-1 inhibitors in treating relapsed or refractory cHL (rrHL). Methods. We searched PubMed, MEDLINE, Embase, Cochrane Central Register of Controlled Trials, China National Knowledge Infrastructure, Wanfang, Chinese Biological Medical Literature, and Abstracts of Conference proceedings of annual meetings without any language restrictions to limit language bias (up to January 2019) for prospective clinical trials that evaluate PD-1 inhibitors in treating relapsed or refractory cHL. Results. A total of 9 prospective clinical trials with 731 patients were included in the meta-analysis. The pooled risks of all-grade and grade ≥3 adverse events (AEs) were 0.86 (95% CI: 0.66–0.98) and 0.21 (95% CI: 0.17–0.24), respectively. The pooled response, complete response, partial response, and stable disease rates were 0.74 (95% CI: 0.70–0.79), 0.24 (95% CI: 0.18–0.34), 0.48 (95% CI: 0.41–0.55), and 0.15 (95% CI: 0.12–0.17), respectively. The pooled 6-month progression-free survival and 1-year overall survival rates were 0.76 (95% CI: 0.72–0.79) and 0.93 (95% CI: 0.90–0.96), correspondingly. Conclusions. Our meta-analysis suggested that anti-PD1 monoclonal antibodies improve the outcomes of response and survival rates with tolerable AEs in cHL. However, evidence of immune checkpoint inhibitors for patients with cHL remained insufficient. Well-designed randomized controlled trials or at least nonrandomized trials with a control group should be conducted to confirm the findings of this meta-analysis.

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