TY - JOUR
T1 - Systematic review on the treatment of deceased organ donors
AU - van Erp, Anne C.
AU - van Dullemen, Leon F. A.
AU - Ploeg, Rutger J.
AU - Leuvenink, Henri G. D.
PY - 2018/10
Y1 - 2018/10
N2 - Background: Currently, there is no consensus on which treatments should be a part of standard deceased-donor management to improve graft quality and transplantation outcomes. The objective of this systematic review was to evaluate the effects of treatments of the deceased, solid-organ donor on graft function and survival after transplantation.Methods: Pubmed, Embase, Cochrane, and Clinicaltrials.gov were systematically searched for randomized controlled trials that compared deceased-donor treatment versus placebo or no treatment.Results: A total of 33 studies were selected for this systematic review. Eleven studies were included for meta-analyses on three different treatment strategies. The meta-analysis on methylprednisolone treatment in liver donors (two studies, 183 participants) showed no effect of the treatment on rates of acute rejection. The meta-analysis on antidiuretic hormone treatment in kidney donors (two studies, 222 participants) indicates no benefit in the prevention of delayed graft function. The remaining meta-analyses (seven studies, 334 participants) compared the effects of 10 min of ischaemic preconditioning on outcomes after liver transplantation and showed that ischaemic preconditioning improved short-term liver function, but not long-term transplant outcomes.Conclusions: There is currently insufficient evidence to conclude that any particular drug treatment or any intervention in the deceased donor improves long-term graft or patient survival after transplantation. (C) 2018 The Authors. Published by Elsevier Inc.
AB - Background: Currently, there is no consensus on which treatments should be a part of standard deceased-donor management to improve graft quality and transplantation outcomes. The objective of this systematic review was to evaluate the effects of treatments of the deceased, solid-organ donor on graft function and survival after transplantation.Methods: Pubmed, Embase, Cochrane, and Clinicaltrials.gov were systematically searched for randomized controlled trials that compared deceased-donor treatment versus placebo or no treatment.Results: A total of 33 studies were selected for this systematic review. Eleven studies were included for meta-analyses on three different treatment strategies. The meta-analysis on methylprednisolone treatment in liver donors (two studies, 183 participants) showed no effect of the treatment on rates of acute rejection. The meta-analysis on antidiuretic hormone treatment in kidney donors (two studies, 222 participants) indicates no benefit in the prevention of delayed graft function. The remaining meta-analyses (seven studies, 334 participants) compared the effects of 10 min of ischaemic preconditioning on outcomes after liver transplantation and showed that ischaemic preconditioning improved short-term liver function, but not long-term transplant outcomes.Conclusions: There is currently insufficient evidence to conclude that any particular drug treatment or any intervention in the deceased donor improves long-term graft or patient survival after transplantation. (C) 2018 The Authors. Published by Elsevier Inc.
KW - Systematic review
KW - Deceased donor
KW - Brain death
KW - Organ
KW - Treatment
KW - Management
KW - RANDOMIZED CONTROLLED-TRIAL
KW - ISCHEMIA-REPERFUSION INJURY
KW - POTENTIAL HEART-DONORS
KW - TRAUMATIC BRAIN-INJURY
KW - ACUTE LUNG INJURY
KW - LIVER-TRANSPLANTATION
KW - THERAPEUTIC HYPOTHERMIA
KW - RENAL-TRANSPLANTATION
KW - CLINICAL-TRIALS
KW - GENE-EXPRESSION
U2 - 10.1016/j.trre.2018.06.001
DO - 10.1016/j.trre.2018.06.001
M3 - Review article
SN - 0955-470X
VL - 32
SP - 194
EP - 206
JO - Transplantation Reviews
JF - Transplantation Reviews
IS - 4
ER -