Normothermic Machine Perfusion Of Liver Transplantation A Meta Analysis

Objective: Systematically assessment clinical use of normothermic machine perfusion in liver transplantation.Compare their advantages and disadvantages over traditional preservation methods,and provide theoretical basis for clinical application of normothermic machine perfusion of liver transplantation.Methods: Use Me SH terms of liver transplantation : Transplantation,Liver、Liver Transplantations、Transplantations,Liver、Transplantation,Hepatic、Hepatic Transplantation、Hepatic Transplantations、Transplantations,Hepatic、Grafting,Liver、Liver Grafting;Me SH terms of Normothermic machine perfusion and Me SH terms of static cold storage for the key words.Literatures have been searched by using EMbase、Pub Med、The Cochrane Library、Web of Science、CNKI、WANFANG DATA、VIP DATA from 1968 Jan to 2019.Oct.RCT and CCT were required for this review.The statistical analysis of EAD,PNF,postoperative complications,peak serum bilirubin after the operation in 7 days,peak serum AST after operation in 7 days.SMD and 95%CI were required for continuous variable.And for dichotomous OR and 95%CI were.2test was used for analyzing studies heterogeneity.Rev Man 5.3 version was used for this review.Result:We identified 349 studies,and 60 studies were review.The language in Chinese of these studies were 74,the rest 275 studies were in English.All the review studies,conference reports,case reports were excluded for this review.Six studies were included for this review,and two of them were RCT studies the rest of studies were CCT studies.The total patients were 421,and they divided into NMP group with 183 patients the rest 283 patients were in the CS group.The incidence of EAD is stati-stically different between NMP group and CS group[P=0.002 OR=0.37,95%CI:0.20-0.68].The incidence of PNF have no statistically differenct between NMP group and CS group[P=0.57,OR=2.53,95%CI:0.10-62.71].The incidence of postoperative complications have statistically differenct between NMP group and CS group[P=0.01,OR=0.39,95%CI:0.22-0.69].There isn’t statistically difference for postoperative serum bilirubin level in 7days between NMPgroup and CS group[P=0.58,SMD=0.06,95%CI:-0.26,0.14].Statistically difference for postoperative serum AST level in 7days was found in both groups [P=0.13,SMD=-0.60,95%CI:-0.81,0.40]Conclusion: Using NMP for liver transplantation can reduce EAD and postoperative serum AST level compared to the static cold storage.No diff-erence was found between NMP group and CS group in postoperative serum bil-irubin.Use NMP for DCD donors is feasible.