SynthesisTransplant international : official journal of the European Society for Organ Transplantation2026
Normothermic regional perfusion in controlled donation after circulatory death liver transplantation: an updated systematic review and meta-analysis versus non-NRP and brain-death donors.
Synthesis in Transplant international : official journal of the European Society for Organ Transplantation, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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6 authors.
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Abstract
Normothermic regional perfusion (NRP) may mitigate ischemic injury in controlled donation after circulatory death (cDCD) liver transplantation. We updated the most recent meta-analysis (search closed June 2023) by incorporating subsequent evidence and comparing NRP with non-NRP cDCD and with donation after brain death (DBD). We performed a systematic review of five databases and random-effects meta-analyses; dichotomous outcomes were pooled as risk ratios, the Mantel-Haenszel estimator was preferred for rare events, pooled incidences used a logit-binomial model, risk of bias was assessed with ROBINS-I and certainty with GRADE. Twenty observational studies were included (1776 NRP-cDCD liver recipients). Versus non-NRP cDCD, NRP reduced ischemic cholangiopathy (risk ratio 0.16, 95% confidence interval 0.09-0.28; number needed to treat 9), graft loss (0.41, 0.32-0.54), recipient death (0.46, 0.34-0.62), hepatic artery thrombosis (0.51, 0.30-0.85), other biliary complications (0.49, 0.32-0.73) and primary non-function (0.51, 0.28-0.94); these reductions persisted after excluding grafts managed with Systematic Review Registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD420261404939, identifier PROSPERO CRD420261404939.
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