Vascular closure devices in living-donor nephrectomy: a much-needed systematic review and meta-analysis focusing on safety.
clip
living-donor nephrectomy
safety
stapler
vascular control
Journal
BJU international
ISSN: 1464-410X
Titre abrégé: BJU Int
Pays: England
ID NLM: 100886721
Informations de publication
Date de publication:
09 2023
09 2023
Historique:
medline:
16
8
2023
pubmed:
6
4
2023
entrez:
5
4
2023
Statut:
ppublish
Résumé
To assess the safety of vascular closure devices in living-donor nephrectomy (LDN), as staplers and non-transfixion techniques (polymer locking and metal clips) are the methods employed to secure the renal vessels during laparoscopic and robotic LDN, but the use of clips has come into question since the United States Food and Drug Administration and manufacturers issued a contraindication. A systematic review and meta-analysis were conducted to assess the safety of vascular closure devices (International Prospective Register of Systematic Reviews [PROSPERO] registration: CRD42022364349). The PubMed, Scopus, the Excerpta Medica dataBASE (EMBASE), and the Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS) databases were searched in September 2022. For comparative and non-comparative studies, incidence estimates and odds ratios (ORs), respectively, for the main variables regarding safety of vascular closure devices were pooled by using random effects meta-analyses. Quality assessment of the included comparative studies was conducted using the Risk Of Bias In Non-randomised Studies of Interventions (ROBINS-I) tool. Of the 863 articles obtained, data were retrieved from 44 studies, which included 42 902 patients. In non-comparative studies, the pooled estimate rates for device failure, severe haemorrhage rate, conversion to open surgery, and mortality were similar for both clips and staplers. Regarding the meta-analyses for comparative studies (three studies), there were no significant differences between the two groups for the severe haemorrhage rate (OR 0.57, 95% confidence interval [CI] 0.18-1.75; P = 0.33), conversion to open surgery (OR 0.35, 95% CI 0.08-1.54; P = 0.16), or death rate (OR 3.64, 95% CI 0.47-28.45; P = 0.22). Based on weak evidence, device failure was lower in the polymer clip group (OR 0.41, 95% CI 0.23-0.75; P = 0.00). This study has confirmed that there is no evidence for the superiority of any vascular closure device in terms of safety in LDN. Standardised recommendations for vascular control in this context should be carefully designed and prospectively evaluated.
Substances chimiques
Polymers
0
Types de publication
Meta-Analysis
Systematic Review
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
239-251Informations de copyright
© 2023 BJU International.
Références
de la Oliva Valentín M, Hernández D, Crespo M et al. Live donor kidney transplantation. Situation analysis and roadmap. Nefrologia 2021; 42: 85-93
McGregor TB, Patel P, Sener A, Chan G. Vascular control during laparoscopic kidney donation. Can J Surg 2017; 60: 150-1
Alcaraz A, Rosales A, Guirado L, Díaz JM, Musquera M, Villavicencio H. Early experience of a living donor kidney transplant program. Eur Urol 2006; 50: 542-8
Kidney transplants set new record in 2021 following policy change - UNOS [Internet]. Available at: https://unos.org/news/in-focus/2021-kidney-transplants-set-record-with-policy-change/ Accessed October 2022
Silvestre C, Neri F, Tuci F, Rigotti P, Furian L. Safety of the living kidney donor: what's to be improved? Transpl Int 2017; 30: 258
Tena-González-Méndez G, Peña-Islas MA, Hernández-Pañeda H, Gabilondo-Pliego B, Rodríguez-Covarrubias FT. Polymer clips (hem-o-lok®) for renal vessel control in laparoscopic living donor nephrectomy: 12 years of experience in a tertiary care center. Rev Mex Urol 2022; 82: 1-10
García-Baquero R, Fernández-Ávila CM, Salvatierra Pérez C, García Álvarez TM, Ledo Cepero MJ, Álvarez-Ossorio Fernández JL. Living-donor renal transplant. State of the art. Arch Esp Urol 2021; 74: 979-90
Friedman AL, Peters TG, Ratner LE. Clips and the live kidney donor's renal artery: the threat to life continues. Am J Transplant 2012; 12: 449-50
Figueiredo A. Laparoscopic living donor nephectomy: safety issues How to best secure the pedicle? EAU16 Congress. Munich; 11-15th March, 2016
ROBINS-I | Cochrane Bias [Internet]. Available at: https://methods.cochrane.org/bias/risk-bias-non-randomized-studies-interventions Accessed September 2022
Wan X, Wang W, Liu J, Tong T. Estimating the sample mean and standard deviation from the sample size, median, range and/or interquartile range. BMC Med Res Methodol 2014; 14: 1-13
Lin L, Chu H, Murad MH et al. Empirical comparison of publication bias tests in meta-analysis. J Gen Intern Med 2018; 33: 1260-7
Fallatah M, Aldughiman AW, Binjawhar AS et al. Renal pedicle control in laparoscopic donor nephrectomy: evaluation of a single-center experience. Urol Ann 2022; 14: 152-5
Pedraza NF, Garcia AE, Amaya JA, Baez Y, Giron F. Vascular control of the renal pedicle using non-absorbable polymer ligating clips in hand-assisted living donor laparoscopic nephrectomies. Nephrourol Mon 2019; 11: e91761
Hsi RS, Ojogho ON, Baldwin DD. Analysis of techniques to secure the renal hilum during laparoscopic donor nephrectomy: review of the FDA database. Urology 2009; 74: 142-7
Goh YSB, Cheong PSC, Lata R et al. A necessary step toward kidney donor safety: the transition from locking polymer clips to transfixion techniques in laparoscopic donor nephrectomy. Transplant Proc 2014; 46: 310-3
Bittner JG IV, Sajadi K, Brown JA. Comparison of renal artery occlusion techniques in hand-assisted laparoscopic living donor nephrectomy. J Endourol 2009; 23: 933-7
Kim BS, Cho DH, Kim HT, Kim KH, Yoo ES, Kwon TG. Comparison of endo-GIA stapler and hem-o-lok clip for the vascular control during laparoscopic nephrectomy. Korean J Urol 2007; 48: 120-4
Siqueira TMJ, Mitre AI, Simoes FA et al. A cost-effective technique for pure laparoscopic live donor nephrectomy. Int Braz J Urol 2006; 32: 23-30
Liu K-L, Chiang Y-J, Wang H-H, Chu S-H. Techniques of vascular control in laparoscopic donor nephrectomy. Transplant Proc 2008; 40: 2342-4
Kaushik M, Bagul A, Yates PJ, Elwell R, Nicholson ML. Comparison of techniques of vascular control in laparoscopic donor nephrectomy: the Leicester experience. Transplant Proc 2006; 38: 3406-8
Chueh S-CJ, Wang S-M, Lai M-K. Use of hem-o-lok clips effectively lengthens renal vein during laparoscopic live donor nephrectomy. Transplant Proc 2004; 36: 2623-4
Matas AJ, Bartlett ST, Leichtman AB, Delmonico FL. Morbidity and mortality after living kidney donation, 1999-2001: survey of United States transplant centers - PubMed. Am J Transpl 2003; 3: 830-4
Matas AJ, Payne WD, Sutherland DE et al. 2,500 living donor kidney transplants: a single-center experience. Ann Surg 2001; 234: 149-64
Liu Y, Huang Z, Chen Y et al. Staplers or clips?: A systematic review and meta-analysis of vessel controlling devices for renal pedicle ligation in laparoscopic live donor nephrectomy. Medicine 2018; 97: e13116
Izaki H, Fukawa T, Kanayama H-O. Hem-o-lok clips for renal vascular control: points of controversy: letter to the editor. Int J Urol 2009; 16: 217
Izaki H, Fukumori T, Takahashi M et al. Clinical research of renal vein control using hem-o-lok clips in laparoscopic nephrectomy. Int J Urol 2006; 13: 1147-9
Weck® Ligation Solutions. Metal and polymer products to help you ligate with security and confidence [Internet]. Available at: https://www.teleflex.com/usa/en/product-areas/surgical/ligation-solutions/weck-metal-ligation/Weck-Ligation-Solutions_Catalog.pdf Accessed September 2022
Yip SKH, Tan YH, Cheng C, Sim HG, Lee YM, Chee C. Routine vascular control using the Hem-o-lok clip in laparoscopic nephrectomy: animal study and clinical application. J Endourol 2004; 18: 77-81
Janki S, Klop K, Friedman A et al. Vascular management during live donor nephrectomy-an online survey among esot surgeons. Transpl Int 2013; 26: 173
Castro de la Nuez P, García Álvarez T, Agüera Morales Aragón M et al. Informe donante renal vivo. Memoria de resultados. España 2010-2017. España: Organización Nacional de Trasplantes; 2020
Sundaram CP, Bargman V, Bernie JE. Methods of vascular control during laparoscopic donor nephrectomy. J Endourol 2006; 20: 467-70
Kumar A, Chaudhary H, Srivastava A, Raghavendran M. Laparoscopic live-donor nephrectomy: modifications for developing nations. BJU Int 2004; 93: 1291-5
Vu LN, Nghia NQ, Thanh DT et al. Laparoscopic living donor right nephrectomy: assessment of outcome and association of BMI to length of right renal vein. Actas Urol Esp 2019; 43: 536-42
Kohei N, Kazuya O, Hirai T et al. Retroperitoneoscopic living donor nephrectomy: experience of 425 cases at a single center. J Endourol 2010; 24: 1783-7
Yashi M, Yagisawa T, Ishikawa N, Nukui A, Fujiwara T, Sakuma Y. Retroperitoneoscopic hand-assisted live-donor nephrectomy according to the basic principle of transplantation in donor kidney selection. J Endourol 2007; 21: 589-94
Frutos MÁ, Crespo M, Valentín M et al. Recommendations for living donor renal transplantation. Nefrol (English Ed) 2022; 42(Supplement 2): 5-132
Lai WS, Rais-Bahrami S. Safety and efficacy of En bloc renal hilar vascular staple ligation: a meta-analysis. J Urol 2017; 197: 175-81
Lam NN, Dipchand C, Fortin MC et al. Canadian Society of Transplantation and Canadian Society of nephrology commentary on the 2017 KDIGO clinical practice guideline on the evaluation and care of living kidney donors. Can J Kidney Heal Dis 2020; 7: 2054358120918457
Breda A, Budde K, Figueiredo A et al. Renal Transplantation EAU Guidelines. Arnhem: EAU Guidelines Office; 2022
Guidelines for Living Donor Kidney Transplantation. United Kingdom. 2018. Available at: www.bts.org.uk Accessed October 2022