Abstract / Summary
Liver transplantation is a life-saving treatment for end-stage liver disease. However, the shortage of organs and complexity of donor-recipient matching remain major challenges. Accurate pre-transplant assessment of matching variables is crucial to improve allocation and enhance outcomes such as patient survival, graft survival, and reduced dysfunction. To systematically review evidence on donor-recipient matching variables that predict patient survival, graft survival, and graft dysfunction in adult liver transplantation from brain-dead cadaveric donors. This systematic review followed PRISMA and MOOSE guidelines and was registered in PROSPERO (CRD42024593301). A comprehensive literature search was conducted in June 2024 using PubMed, LILACS, and Medline Ovid. Eligible studies were selected using PECOS criteria. Two independent reviewers conducted study screening, and data extraction, the risk of bias, and methodological quality of included studies were assessed using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Cohort Studies Certainty of evidence was evaluated using the GRADE framework. From 735 records, 8 retrospective cohort studies met inclusion criteria. Variables associated with patient survival included recipient age, hepatitis C infection, retransplantation within 30 days, and low platelet count. Graft survival was influenced by MELD score, donor age, cold ischemia time, retransplantation, sex mismatch, and blood type. Graft dysfunction was related to recipient and donor age, hepatitis C, retransplantation, ischemia time, and low platelet count. Meta-analysis was not feasible. Post-transplant outcomes are multifactorial. Developing robust, multidimensional donor-recipient matching strategies is essential to optimize liver transplant success and organ utilization.