Venous outflow reconstruction of the anterior sector (V5/V8) in right-lobe living donor liver transplantation: meta-analysis

Zhambyl Оspan, Bolatbek B. Baimakhanov, Erbol Serikuly, Shokan Kaniyev, Serik Tileuov, Remzi Emiroglu, Allan Abdiev

2026

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DOI 10.35805/bsk2026iii007
Data confidence 70 medium
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Abstract

Background. Reconstruction of anterior sector (V5/V8] venous outflow is a critical component of right-Lobe living donor tiver transplantation to prevent venous congestion, graft dysfunction, and postoperative vascular complications. Materials and Methods. A meta-analysis was conducted according to the PRISMA guidelines. PubMed/MEDLINE, Embase, Scopus, Web of Science, and the Cochrane Library were searched for comparative studies evaluating vascular conduits for anterior sector reconstruction during right-Lobe LDLT. Pooled ORs with 95% Cl were calculated using a randomeffects model. Between-study heterogeneity, sensitivity analysis, and publication bias were assessed. Results. Twelve comparative studies involving 3,370 patients were included. The overall pooled analysis yielded an OR of 1.38 (95% Cl: 0.96~1.98; p = 0.079] with substantial heterogeneity (= 64.6%). Subgroup analysis demonstrated significantly higher graft patency with biological/autologous venous conduits than with synthetic prostheses (OR = 1.92; 95% Cl: 1.38-2.68; p < 0.001). Cryopreserved venous allografts showed intermediate clinical performance (OR = 1.61; 95% Cl: 1.06-2.45; p = 0.026). Sensitivity analysis confirmed the robustness of the findings, and no significant publication bias was detected Conclusion. Although the overall pooled analysis showed only favorable trend toward improved graft patency, subgroup analyses demonstrated superior outcomes with biologicaV/autologous venous conduits compared with synthetic prostheses. Cryopreserved venous allografts may represent a reasonable alternative when autologous veins are una~ vailable. Further prospective multicenter studies are warranted.