Outcomes of ABO-Incompatible Versus ABO-Compatible Liver Transplantation in Pediatric Recipients: An Updated Systematic Review and Meta-Analysis.
Kalpana Panda, Bikrant Bihari Lal, Rajeev Khanna et al.
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In 30 seconds
This systematic review and meta-analysis evaluated outcomes of ABO-incompatible (ABO-i) versus ABO-compatible (ABO-c) liver transplantation in pediatric recipients. Seventeen studies were analyzed, revealing comparable patient survival rates at 1, 3, and 5 years (risk ratios of 0.97, 0.98, and 0.97, respectively). However, antibody-mediated rejection was significantly higher in ABO-i recipients (RR: 20.04).
Key findings
- Patient survival rates at 1 year were 0.97 for ABO-i versus ABO-c (p=0.07).
- Graft survival rates showed no significant differences between ABO-i and ABO-c groups.
- Antibody-mediated rejection was significantly higher in ABO-i recipients (RR: 20.04, p=0.001).
- Incidence of vascular and biliary complications did not differ significantly between the two groups.
Why it matters
Understanding the outcomes of ABO-i liver transplantation is crucial for clinicians addressing organ shortages in pediatric patients. This analysis provides insights into survival and complication rates, informing decision-making in transplant practices.
What to keep in mind
The certainty of evidence was rated as very low due to the observational design of the included studies and associated risk of bias.