Prophylactic Activated Recombinant Factor VII in Liver Resection and Liver Transplantation Systematic Review and Meta-Analysis 英文参考文献.docVIP

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Prophylactic Activated Recombinant Factor VII in Liver Resection and Liver Transplantation Systematic Review and Meta-Analysis 英文参考文献.doc

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Prophylactic Activated Recombinant Factor VII in Liver Resection and Liver Transplantation Systematic Review and Meta-Analysis 英文参考文献

ProphylacticActivatedRecombinantFactorVIIinLiver ResectionandLiverTransplantation:SystematicReview andMeta-Analysis NorbertoC.Chavez-Tapia1*,RobertoAlfaro-Lara1,FelixTellez-Avila2,TonatiuhBarrientos-Gutie′rrez3, OctavioGonza′lez-Chon4,NahumMendez-Sanchez1,MisaelUribe1 1Obesity and Digestive Diseases Unit, Medica Sur Clinic and Foundation, Mexico City, Mexico, 2Endoscopy Department, Instituto Nacional de Ciencias Me′dicas y Nutricio′nSalvadorZubira′n, MexicoCityMexico,3NationalInstituteofPublicHealth.MexicoCity,Mexico,4CardiologyDepartment,MedicaSurClinicandFoundation, MexicoCity,Mexico Abstract Background and Aim: Intraoperative blood loss is a frequent complication of hepatic resection and orthotopic liver transplantation.RecombinantactivatedcoagulationfactorVII(rFVIIa)isacoagulationproteinthatinduceshemostasisby directly activating factor X. There is no clear information about the prophylactic value of rFVIIa in hepatobiliary surgery, specificallyinliverresectionandorthotopiclivertransplantation.Theaimofthisstudy wastoassesstheeffectofrFVIIa prophylaxistopreventmortalityandbleedingresultingfromhepatobiliarysurgery. Methods: Relevant randomized trials were identified by searching The Cochrane Central Register of Controlled Trials in The CochraneLibrary,MEDLINE,EMBASE,andScienceCitationIndex.RandomizedclinicaltrialscomparingdifferentrFVIIaprophylactic schemasagainstplaceboornointerventiontopreventbleedinginhepatobiliarysurgerywereincluded.Adultsundergoingliver resection,partialhepatectomy,ororthotopiclivertransplantationwereincluded.Dichotomousdatawereanalyzedcalculatingodds ratios(ORs)and95%confidenceintervals(CIs).Continuousdatawereanalyzedcalculatingmeandifferences(MD)and95%CIs. Results:Fourrandomizedcontrolledtrialswereincluded.TherewerenosignificantdifferencesbetweenrFVIIaandplacebo formortality(OR0.96;95%CI0.35–2.62),redbloodcellunits(MD0.32;95%CI20.08–0.72)oradverseevents(OR1.55;95% CI0.97–2.49). Conclusions:Theavailableinformationislimited,precludi