Evidence map›Paper›PMID 30983822›Full record

SynthesisWorld journal of gastroenterology2019

Systematic review with meta-analysis on transplantation for alcohol-related liver disease: Very low evidence of improved outcomes.

Nicole T Shen, Cristina Londono, Stephanie Gold, Ashley Wu, Keith C Mages, Robert S Jr Brown

Open access · bronzeAbstract readComparative StudyMeta-AnalysisSystematic Review
In one paragraph

Synthesis in World journal of gastroenterology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.5field-weighted citation impact, top 36% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 3 citations in OpenAlex.

  1. Review
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 2 institutions in 1 country.

Nicole T ShenDepartment of Medicine, Division of Gastroenterology and Hepatology, Weill Cornell Medicine, New York, NY 10021, United States. nts9004@nyp.org.
Cristina LondonoDepartment of Medicine, Weill Cornell Medical College, New York, NY 10021, United States.
Stephanie GoldDepartment of Medicine, Division of Internal Medicine, Weill Cornell Medicine, New York, NY 10021, United States.
Ashley WuDepartment of Medicine, Weill Cornell Medical College, New York, NY 10021, United States.
Keith C MagesDepartment of Medicine, Weill Cornell Medical College, Samuel J. Wood Library and C.V. Starr Biomedical Information Center, New York, NY 10021, United States.
Robert S Jr BrownDepartment of Medicine, Division of Gastroenterology and Hepatology, Weill Cornell Medicine, New York, NY 10021, United States.
Cornell University · USWeill Cornell Medicine · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAlcohol-related liver disease (ALD) is a leading cause of liver failure and indication for liver transplantation that arises in the setting of alcohol use disorder (AUD). Previous reviews of transplantation for ALD are limited in scope of outcomes and type of ALD studied. A comprehensive systematic review could improve use of transplantation in ALD and improve future research. We hypothesize that while transplanting ALD may improve mortality and relapse, findings will be limited by pre-specified causes of heterogeneity - assessment and treatment of AUD, definition of ALD, spectrum of ALD studied, assessment and rates of relapse, and study quality and bias.

aimTo optimize liver transplantation for ALD, understanding existing research to guide future research, we conducted a systematic review with meta-analysis.

methodsWe conducted a systematic review, comparing liver transplant to no-transplant in patients with ALD, with a primary outcome of both short- and long-term mortality and relapse. We performed a comprehensive search of MEDLINE, EMBASE, Web of Science, and The Cochrane Library databases for peer-reviewed journal articles comparing use of liver transplant in ALD to no-transplant. Two reviewers independently conducted screening, full text review, and data extraction according to the PRISMA guidelines. We report the quality of the evidence according to the GRADE criteria.

resultsWe analyzed data from 10 studies. Of 1332 participants, 34.2% (456/1332) had undergone liver transplantation, while 65.8% (876/1332) had not. While random effects meta-analysis suggested transplant in comparison to no-transplant had an association of reduced mortality that did not reach statistical significance, relative risk (RR) = 0.51 (0.25-1.05), but not relapse risk, RR = 0.52 (0.18-1.53), significant heterogeneity limited these findings. When restricted to prospective data, transplant compared to no-transplant significantly reduced mortality, RR = 0.25 (0.13-0.46,

conclusionSystematic review of liver transplantation for ALD suggests reduced mortality and relapse in heterogeneous, institution-specific populations with inherent bias. To understand efficacy of transplanting ALD, our research approach must change.

Indexed as

Disease ProgressionEnd Stage Liver DiseaseHumansLiver Diseases, AlcoholicLiver TransplantationOutcome Assessment, Health CareRecurrenceResearch DesignTreatment OutcomeAlcohol-related cirrhosisAlcohol-related hepatitisAlcohol use disorderLiver transplantationStandardization

Identifiers

PMID30983822
PMCPMC6452234
OpenAlexW2930480149

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.