Optimizing pre-donation physiologic evaluation for enhanced recovery after living liver donation - Systematic review and multidisciplinary expert panel recommendations.
cardiopulmonary testing
liver transplantation
living liver donor
preoperative testing
Journal
Clinical transplantation
ISSN: 1399-0012
Titre abrégé: Clin Transplant
Pays: Denmark
ID NLM: 8710240
Informations de publication
Date de publication:
Oct 2022
Oct 2022
Historique:
revised:
04
04
2022
received:
16
01
2022
accepted:
09
04
2022
pubmed:
4
5
2022
medline:
15
12
2022
entrez:
3
5
2022
Statut:
ppublish
Résumé
While preoperative physiologic evaluation of live liver donors is routinely performed to ensure donor safety and minimize complications, the optimal approach to this evaluation is unknown. We aim to identify predonation physiologic evaluation strategies to improve postoperative short-term outcomes, enhance donor's recovery, and reduce length of stay. We also aim to provide multidisciplinary expert panel recommendations. Ovid MEDLINE, Embase, Scopus, Google Scholar, and Cochrane Central. The systematic review followed PRISMA guidelines, and the recommendations were formulated using GRADE approach and experts' opinion. The search included retrospective or prospective studies, describing outcomes of physiologic evaluation predonation. The outcomes of interest were length of stay, postoperative complications (POC), recovery after donation, and mortality. PROSERO protocol ID CRD42021260662. Of 1386 articles screened, only three retrospective cohort studies met eligibility criteria. Two studies demonstrated no impact of age (< 70 years) on POC. Increased body mass index's (BMI) association with POC was present in one study (23.8 vs 21.7 kg/m Advancing age (60-69 years) is not a contraindication for liver donation. There is insufficient evidence for a specific predonation BMI cut-off. Abbreviated predonation physiologic testing is recommended in all candidates. Comprehensive testing is recommended in high-risk candidates while considering the pretest probability in various populations (Quality of evidence; Low to Very Low | Grade of Recommendation; Strong).
Sections du résumé
BACKGROUND
BACKGROUND
While preoperative physiologic evaluation of live liver donors is routinely performed to ensure donor safety and minimize complications, the optimal approach to this evaluation is unknown.
OBJECTIVES
OBJECTIVE
We aim to identify predonation physiologic evaluation strategies to improve postoperative short-term outcomes, enhance donor's recovery, and reduce length of stay. We also aim to provide multidisciplinary expert panel recommendations.
DATA SOURCES
METHODS
Ovid MEDLINE, Embase, Scopus, Google Scholar, and Cochrane Central.
METHODS
METHODS
The systematic review followed PRISMA guidelines, and the recommendations were formulated using GRADE approach and experts' opinion. The search included retrospective or prospective studies, describing outcomes of physiologic evaluation predonation. The outcomes of interest were length of stay, postoperative complications (POC), recovery after donation, and mortality. PROSERO protocol ID CRD42021260662.
RESULTS
RESULTS
Of 1386 articles screened, only three retrospective cohort studies met eligibility criteria. Two studies demonstrated no impact of age (< 70 years) on POC. Increased body mass index's (BMI) association with POC was present in one study (23.8 vs 21.7 kg/m
CONCLUSION
CONCLUSIONS
Advancing age (60-69 years) is not a contraindication for liver donation. There is insufficient evidence for a specific predonation BMI cut-off. Abbreviated predonation physiologic testing is recommended in all candidates. Comprehensive testing is recommended in high-risk candidates while considering the pretest probability in various populations (Quality of evidence; Low to Very Low | Grade of Recommendation; Strong).
Types de publication
Journal Article
Review
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
e14680Investigateurs
Nolitha Morare
(N)
Alejandro Ramirez
(A)
Claus Niemann
(C)
Joerg-Matthias Pollok
(JM)
Marina Berenguer
(M)
Pascale Tinguely
(P)
Jonathan Potts
(J)
Carlo Frola
(C)
Informations de copyright
© 2022 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Références
Kim D, Li AA, Perumpail BJ, et al. Changing trends in etiology-based and ethnicity-based annual mortality rates of cirrhosis and hepatocellular carcinoma in the United States. Hepatology. 2019;69(3):1064-1074.
Database. UNoOS. https://unos.org/data/ Accessed 11/26, 2021.
Li GQ, Zhang F, Li XC, et al. Safety evaluation of donors for living-donor liver transplantation in Chinese mainland: a single-center report. World J Gastroenterol. 2007;13(32):4379-4384.
Lauterio A, Di Sandro S, Gruttadauria S, et al. Donor safety in living donor liver donation: an Italian multicenter survey. Liver Transpl. 2017;23(2):184-193.
Cheah YL, Simpson MA, Pomposelli JJ, Pomfret EA. Incidence of death and potentially life-threatening near-miss events in living donor hepatic lobectomy: a world-wide survey. Liver Transpl. 2013;19(5):499-506.
Barr ML, Belghiti J, Villamil FG, et al. A report of the Vancouver Forum on the care of the live organ donor: lung, liver, pancreas, and intestine data and medical guidelines. Transplantation. 2006;81(10):1373-1385.
Morimoto T, Ichimiya M, Tanaka A, et al. Guidelines for donor selection and an overview of the donor operation in living related liver transplantation. Transpl Int. 1996;9(3):208-213.
Kadohisa M, Inomata Y, Uto K, et al. Impact of donor age on the outcome of living-donor liver transplantation: special consideration to the feasibility of using elderly donors. Transplantation. 2021;105(2):328-337.
Moher D, Liberati A, Tetzlaff J, Altman DG, Group P. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. BMJ. 2009;339:b2535.
Guyatt G, Oxman AD, Akl EA, et al. GRADE guidelines: 1. Introduction-GRADE evidence profiles and summary of findings tables. J Clin Epidemiol. 2011;64(4):383-394.
Murad MH, Mustafa RA, Schunemann HJ, Sultan S, Santesso N. Rating the certainty in evidence in the absence of a single estimate of effect. Evid Based Med. 2017;22(3):85-87.
Andrews J, Guyatt G, Oxman AD, et al. GRADE guidelines: 14. Going from evidence to recommendations: the significance and presentation of recommendations. J Clin Epidemiol. 2013;66(7):719-725.
Andrews JC, Schunemann HJ, Oxman AD, et al. GRADE guidelines: 15. Going from evidence to recommendation-determinants of a recommendation's direction and strength. J Clin Epidemiol. 2013;66(7):726-735.
Yoshino K, Taura K, Ikeno Y, et al. Low preoperative platelet count predicts risk of subclinical posthepatectomy liver failure in right lobe donors for liver transplantation. Liver Transpl. 2018;24(9):1178-1185.
Knaak M, Goldaracena N, Doyle A, et al. Donor BMI >30 is not a contraindication for live liver donation. Am J Transplant. 2017;17(3):754-760.
Rahbari NN, Garden OJ, Padbury R, et al. Posthepatectomy liver failure: a definition and grading by the International Study Group of Liver Surgery (ISGLS). Surgery. 2011;149(5):713-724.
Longbotham D, Young A, Nana G, et al. The impact of age on post-operative liver function following right hepatectomy: a retrospective, single centre experience. HPB (Oxford). 2020;22(1):151-160.
Ji L, Jazwinski SM, Kim S. Frailty and biological age. Ann Geriatr Med Res. 2021;25(3):141-149.
Watt J, Tricco AC, Talbot-Hamon C, et al. Identifying older adults at risk of harm following elective surgery: a systematic review and meta-analysis. BMC Med. 2018;16(1):2.
Williams FR, Milliken D, Lai JC, Armstrong MJ. Assessment of the frail patient with end-stage liver disease: a practical overview of sarcopenia, physical function, and disability. Hepatol Commun. 2021;5(6):923-937.
Pan WH, Yeh WT. How to define obesity? Evidence-based multiple action points for public awareness, screening, and treatment: an extension of Asian-Pacific recommendations. Asia Pac J Clin Nutr. 2008;17(3):370-374.
Moss J, Lapointe-Rudow D, Renz JF, et al. Select utilization of obese donors in living donor liver transplantation: implications for the donor pool. Am J Transplant. 2005;5(12):2974-2981.
Benjamin ER, Dilektasli E, Haltmeier T, Beale E, Inaba K, Demetriades D. The effects of body mass index on complications and mortality after emergency abdominal operations: the obesity paradox. Am J Surg. 2017;214(5):899-903.
Wilding JPH, Batterham RL, Calanna S, et al. Once-weekly semaglutide in adults with overweight or obesity. N Engl J Med. 2021;384(11):989.
Luo X, Li F, Hu H, et al. Anemia and perioperative mortality in non-cardiac surgery patients: a secondary analysis based on a single-center retrospective study. BMC Anesthesiol. 2020;20(1):112.
Liem TK, Huynh TM, Moseley SE, et al. Symptomatic perioperative venous thromboembolism is a frequent complication in patients with a history of deep vein thrombosis. J Vasc Surg. 2010;52(3):651-657.
Stegeman BH, de Bastos M, Rosendaal FR, et al. Different combined oral contraceptives and the risk of venous thrombosis: systematic review and network meta-analysis. BMJ. 2013;347:f5298.
Hernandez AF, Whellan DJ, Stroud S, Sun JL, O'Connor CM, Jollis JG. Outcomes in heart failure patients after major noncardiac surgery. J Am Coll Cardiol. 2004;44(7):1446-1453.
Oh TK, Park IS, Ji E, Na HS. Value of preoperative spirometry test in predicting postoperative pulmonary complications in high-risk patients after laparoscopic abdominal surgery. PLoS One. 2018;13(12):e0209347.
National Guideline Centre (UK), In: Preoperative Tests (Update): Routine Preoperative Tests for Elective Surgery. London: National Institute for Health and Care Excellence (NICE); 2016. https://pubmed.ncbi.nlm.nih.gov/27077168/
Sankar A, Thorpe KE, Gershon AS, Granton JT, Wijeysundera DN. Association of preoperative spirometry with cardiopulmonary fitness and postoperative outcomes in surgical patients: a multicentre prospective cohort study. EClinicalMedicine. 2020;23:100396.
Pleasants RA, Rivera MP, Tilley SL, Bhatt SP. Both duration and pack-years of tobacco smoking should be used for clinical practice and research. Ann Am Thorac Soc. 2020;17(7):804-806.
Zhao D. Epidemiological features of cardiovascular disease in asia. JACC: Asia. 2021;1(1):1-13.
Kristensen SD, Knuuti J, Saraste A, et al. ESC/ESA Guidelines on non-cardiac surgery: cardiovascular assessment and management: the Joint Task Force on non-cardiac surgery: cardiovascular assessment and management of the European Society of Cardiology (ESC) and the European Society of Anaesthesiology (ESA). Eur Heart J. 2014;35(35):2383-2431.
Cloyd JM, Ma Y, Morton JM, Kurella Tamura M, Poultsides GA, Visser BC. Does chronic kidney disease affect outcomes after major abdominal surgery? Results from the National Surgical Quality Improvement Program. J Gastrointest Surg. 2014;18(3):605-612.