- 2025-10-31
- Medicine 104(44)
Study Design
- Type
- Meta-Analysis
- Population
- 10,007 liver transplant patients
- Methods
- Comprehensive literature search across PubMed, EMBASE, Cochrane Controlled Register of Trials, and Web of Science; studies included if they reported incidence of ALI in liver transplant patients; quality assessed with Newcastle-Ottawa scale; meta-analysis with fixed-effects and random-effects models
Background
End-stage liver disease is associated with significant global morbidity, with liver transplantation being the only curative treatment option. Posttransplant acute lung injury (ALI) and acute respiratory distress syndrome can adversely affect outcomes. This study aimed to evaluate the incidence of ALI following liver transplantation and to identify associated risk factors.Methods
A comprehensive literature search was conducted up to February 24, 2024, across databases such as PubMed, EMBASE, Cochrane Controlled Register of Trials, and Web of Science. Studies were included if they reported the incidence of ALI in liver transplant patients. The quality of the studies was assessed using the Newcastle-Ottawa scale. Data analysis utilized fixed-effects and random-effects models based on heterogeneity, and subgroup analyses investigated the impact of age, region, and study design on ALI incidence. Publication bias was evaluated through funnel plots and Egger's test.Results
The meta-analysis comprised 11 studies from 2000 to 2023, assessing 10,007 liver transplant patients, among whom 198 cases of ALI were reported. Incidence rates varied significantly from 0.1% to 44.6%. The pooled incidence rate was 0.14 (95% confidence interval: 0.06; 0.25), indicative of high heterogeneity (I2 = 97%). Subgroup analyses revealed higher incidence rates in Asian studies and pediatric populations, while retrospective studies reported a lower incidence compared to prospective ones. Publication bias was confirmed.Conclusion
The study found a 14% incidence of lung injury post-liver transplantation, with variation by age and region, underscoring the need for personalized perioperative care and targeted monitoring for high-risk patients.