title: Outcomes of Technical Variant Liver Transplantation versus Whole Liver Transplantation for Pediatric Patients: A Meta-Analysis.
abstract: OBJECTIVE
  To overcome the shortage of appropriate-sized whole liver grafts for children, technical variant liver transplantation has been practiced for decades. We perform a meta-analysis to compare the survival rates and incidence of surgical complications between pediatric whole liver transplantation and technical variant liver transplantation.
  
  
  METHODS
  To identify relevant studies up to January 2014, we searched PubMed/Medline, Embase, and Cochrane library databases. The primary outcomes measured were patient and graft survival rates, and the secondary outcomes were the incidence of surgical complications. The outcomes were pooled using a fixed-effects model or random-effects model.
  
  
  RESULTS
  The one-year, three-year, five-year patient survival rates and one-year, three-year graft survival rates were significantly higher in whole liver transplantation than technical variant liver transplantation (OR = 1.62, 1.90, 1.65, 1.78, and 1.62, respectively, p<0.05). There was no significant difference in five-year graft survival rate between the two groups (OR = 1.47, p = 0.10). The incidence of portal vein thrombosis and biliary complications were significantly lower in the whole liver transplantation group (OR = 0.45 and 0.42, both p<0.05). The incidence of hepatic artery thrombosis was comparable between the two groups (OR = 1.21, p = 0.61).
  
  
  CONCLUSIONS
  Pediatric whole liver transplantation is associated with better outcomes than technical variant liver transplantation. Continuing efforts should be made to minimize surgical complications to improve the outcomes of technical variant liver transplantation.
authors.affiliation: Organ Transplant Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China.
authors.forename: Hui
authors.initials: H
authors.lastname: Ye
authors.affiliation: Organ Transplant Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China.
authors.forename: Qiang
authors.initials: Q
authors.lastname: Zhao
authors.affiliation: Organ Transplant Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China.
authors.forename: Yufang
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Organ Transplant Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China.
authors.forename: Dongping
authors.initials: D
authors.lastname: Wang
authors.affiliation: Organ Transplant Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China.
authors.forename: Zhouying
authors.initials: Z
authors.lastname: Zheng
authors.affiliation: University of Toledo College of Medicine, Toledo, Ohio 43614, United States of America.
authors.forename: Paul Michael
authors.initials: PM
authors.lastname: Schroder
authors.affiliation: Organ Transplant Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China.
authors.forename: Yao
authors.initials: Y
authors.lastname: Lu
authors.affiliation: Organ Transplant Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China.
authors.forename: Yuan
authors.initials: Y
authors.lastname: Kong
authors.affiliation: Organ Transplant Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China.
authors.forename: Wenhua
authors.initials: W
authors.lastname: Liang
authors.affiliation: Organ Transplant Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China.
authors.forename: Yushu
authors.initials: Y
authors.lastname: Shang
authors.affiliation: Organ Transplant Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China.
authors.forename: Zhiyong
authors.initials: Z
authors.lastname: Guo
authors.affiliation: Organ Transplant Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China.
authors.forename: Xiaoshun
authors.initials: X
authors.lastname: He
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006499:Hepatic Artery; D006801:Humans; D007223:Infant; D016031:Liver Transplantation / Q000401:mortality*; D008297:Male; D011183:Postoperative Complications / Q000401:mortality*; D039781:PubMed; D015996:Survival Rate; D013927:Thrombosis / Q000209:etiology / Q000401:mortality*; D013997:Time Factors