Prophylactic Perioperative Terlipressin Therapy for Preventing Acute Kidney Injury in Living Donor Liver Transplant Recipients: A Systematic Review and Meta-Analysis

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dc.article.number102546
dc.article.number102546
dc.contributor.authorKulkarni A.V.
dc.contributor.authorTevethia H.V.
dc.contributor.authorSharma M.
dc.contributor.authorReddy N.D.
dc.contributor.authorRao N.P.
dc.contributor.authorKumar K.
dc.contributor.authorCandia R.
dc.contributor.authorArab J.P.
dc.contributor.authorPremkumar M.
dc.contributor.authorMenon B.
dc.contributor.authorRao G.V.
dc.date.accessioned2025-05-01T10:32:04Z
dc.date.available2025-05-01T10:32:04Z
dc.date.issued2022
dc.description.abstract© 2021 Indian National Association for Study of the LiverBackground: Acute kidney injury (AKI) is common in the perioperative transplant period and is associated with poor outcomes. Few studies reported a reduction in AKI incidence with terlipressin therapy by counteracting the hemodynamic alterations occurring during liver transplantation. However, the effect of terlipressin on posttransplant outcomes has not been systematically reviewed. Methods: A comprehensive search of electronic databases was performed. Studies reporting the use of terlipressin in the perioperative period of living donor liver transplantation were included. We expressed the dichotomous outcomes as risk ratio (RR, 95% confidence interval [CI]) using the random effects model. The primary aim was to assess the posttransplant risk of AKI. The secondary aims were to assess the need for renal replacement therapy (RRT), vasopressors, effect on hemodynamics, blood loss during surgery, hospital and intensive care unit (ICU) stay, and in-hospital mortality. Results: A total of nine studies reporting 711 patients (309 patients in the terlipressin group and 402 in the control group) were included for analysis. Terlipressin was administered for a mean duration of 53.44 ± 28.61 h postsurgery. The risk of AKI was lower with terlipressin (0.6 [95% CI, 0.44–0.8]; P = 0.001). However, on sensitivity analysis including only four randomized controlled trials (I2 = 0; P = 0.54), the risk of AKI was similar in both the groups (0.7 [0.43–1.09]; P = 0.11). The need for RRT was similar in both the groups (0.75 [0.35–1.56]; P = 0.44). Terlipressin therapy reduced the need for another vasopressor (0.34 [0.25–0.47]; P < 0.001) with a concomitant rise in mean arterial pressure and systemic vascular resistance by 3.2 mm Hg (1.64–4.7; P < 0.001) and 77.64 dyne cm−1.sec−5 (21.27–134; P = 0.007), respectively. Blood loss, duration of hospital/ICU stay, and mortality were similar in both groups. Conclusions: Perioperative terlipressin therapy has no clinically relevant benefit.
dc.description.funderFONDECYT
dc.description.funderMarine Energy Research & Innovation Center
dc.format.extent15 páginas
dc.fuente.origenScopus
dc.identifier.doi10.1016/j.jceh.2021.06.019
dc.identifier.eisbn978-84-9880-797-4
dc.identifier.eissn22133453
dc.identifier.isbn978-0-12-817240-7
dc.identifier.issn22133453 09736883
dc.identifier.pubmedid33543637
dc.identifier.scieloidS0718-69242020000300109
dc.identifier.scopusidSCOPUS_ID:85111247180
dc.identifier.urihttps://doi.org/10.1016/j.jceh.2021.06.019
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/103818
dc.identifier.wosidWOS:000771202000021
dc.information.autorucEscuela de Medicina; Candia Balboa Roberto Andres; 0000-0003-1856-7737; 16705
dc.information.autorucEscuela de Medicina; Arab Verdugo Juan Pablo; 0000-0002-8561-396X; 132745
dc.information.autorucEscuela de Medicina; Arab Verdugo Juan Pablo; 0000-0002-8561-396X; 132745
dc.information.autorucEscuela de Medicina; Candia Balboa Roberto Andres; 0000-0003-1856-7737; 16705
dc.issue.numero3515
dc.language.isoen
dc.nota.accesoSin adjunto
dc.pagina.final281
dc.pagina.inicio274
dc.publisherAcademic Press
dc.relation.ispartof7th Workshop On Educational Innovation In Architecture (JIDA), NOV 14-15, 2019, Madrid, SPAIN
dc.revistaJournal of Clinical and Experimental Hepatology
dc.rightsAcceso abierto
dc.subjectacute kidney injury
dc.subjecthemodynamics
dc.subjectportal hypertension
dc.subjectrenal replacement therapy
dc.subjectvasoconstrictors
dc.subject.ddc510
dc.subject.deweyMatemática física y químicaes_ES
dc.subject.ods02 Zero hunger
dc.subject.odspa02 Hambre cero
dc.titleProphylactic Perioperative Terlipressin Therapy for Preventing Acute Kidney Injury in Living Donor Liver Transplant Recipients: A Systematic Review and Meta-Analysis
dc.typeartículo
dc.volumen39
sipa.codpersvinculados16705
sipa.codpersvinculados132745
sipa.codpersvinculados132745
sipa.codpersvinculados16705
sipa.indexScopus
sipa.indexWOS
sipa.trazabilidadCarga WOS-SCOPUS;01-05-2025
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