Survival following right lobe split graft, living- and deceased-donor liver transplantation in adult patients: a systematic review and network meta-analysis

Graft and patient survival outcomes following split liver transplantation (SLT), living-donor liver transplantation (LDLT) and deceased-donor liver transplantation (DDLT) were estimated using Bayesian network meta-analysis. Databases were searched for relevant articles over the previous 20 years (MEDLINE, Embase, Cochrane Library and Google Scholar). Systematic review, pairwise meta-analysis and Bayesian network meta-analysis were performed. Pairwise meta-analysis demonstrated that there were no significant differences in graft and patient survival outcomes. Consequently, Bayesian network meta-analysis demonstrated no significant differences in 1-, 3- and 5-year graft and patient survival between the three alternative liver transplantations. No discrepancies were demonstrated after comparisons of direct and indirect evidence of 1-, 3- and 5-year patient and graft survival of the three node-split models namely SLT, LDLT and DDLT. The 1-, 3- and 5-year graft and patient survival of the SLT and LDLT cohorts compared to the DDLT cohort demonstrated no significant differences. The direct and indirect evidence of this study can serve as comparator for future studies.