P2892 - Outcomes of Liver Transplant in Patients With Budd-Chiari Syndrome: A Systematic Review and Meta-Analysis

Nouman Shafique, MD¹, Fnu Muhibullah, MD, MBBS², Nihal I. Khan, MD¹, Syed Hamaad Rahman, DO³, Adeena Shafique, ⁴, Ali Haider, MD⁵, Iqra Shafiq, MBBS⁶, Zaigham ul Islam, MBBS⁷, Atta Ur Rehman, MBBS⁸, Hassan Nawaz, MBBS⁹, Haris Latif, MD¹⁰, Fnu Poombal, MBBS, MD¹¹, Abu Hurairah, MD^1
1AdventHealth Medical Group, AdventHealth, Orlando, FL; ²West Virginia University Camden Clark Medical Center, Parkersburg, WV; ³Methodist Dallas Medical Center, Irving, TX; ⁴Aga Khan University, Karachi, Sindh, Pakistan; ⁵Nishtar Medical University, Chicago, IL; ⁶Combined Military Hospital, Bahawalpur, Punjab, Pakistan; ⁷Nishtar Medical University, Rajanpur, Punjab, Pakistan; ⁸Nishtar Medical University, Wilkes-Barre, PA; ⁹Nishtar Medical University, Louisville, KY; ¹⁰Nishtar Medical University, Multan, Punjab, Pakistan; ¹¹Baystate Medical Center, Springfield, MA

Introduction: Budd-Chiari syndrome (BCS) is a rare multifactorial condition, characterized by the obstruction of hepatic venous outflow. Liver transplant is one of the terminal treatment modalities offered in patients with BCS. Even though the treatment of BCS has improved significantly over time, the safety and efficacy of liver transplant in BCS is still not well understood and requires further exploration . This systematic review and meta-analysis aims to quantify the outcomes of liver transplant in patients with BCS.

Methods: We conducted a comprehensive search of various databases from their inception to June, 2024. We included studies in which outcomes for liver transplant in patients with budd-chiari syndrome were discussed and quantifiable data was provided. The primary outcome was 5-year survival. Secondary outcome were, biliary stricture, retransplation rate and all-cause mortality. A single-arm random effect meta-analysis of proportions was performed using Generalized Linear Mixed Models (GLMMs) method.

Results: A total of 19 full-text studies were included in the meta-analysis. Total patient population was 1942. Median follow up period was 43 months with a range of 15 months to 120 months (Table). The 5-year survival rate was 76.8% [confidence interval (CI) 74.3%-79.1%, I2= 1%]. The incidence rate for biliary stricture was 18% [Cl 11.9%-26.3%, I2=0%. Retransplantation rate at maximum follow-up period was 6.7% [CI 3.3%-13.4%, I2=77%]. The incidence rate for all-cause mortality was 21.8% [CI 16.3%-28.4%, I2=32%] (Figure).

Discussion: Liver transplant seems to be a safe and effective treatment choice for patients with symptomatic BCS who cannot be treated with non-transplant modalities. However, studies have focused on multiple transplantation techniques on different patient populations leading to high heterogeneity. Further research should focus on conducting randomized controlled trials on safety and efficacy of liver transplant in patients with BCS.



Disclosures:


Nouman Shafique, MD¹, Fnu Muhibullah, MD, MBBS², Nihal I. Khan, MD¹, Syed Hamaad Rahman, DO³, Adeena Shafique, ⁴, Ali Haider, MD⁵, Iqra Shafiq, MBBS⁶, Zaigham ul Islam, MBBS⁷, Atta Ur Rehman, MBBS⁸, Hassan Nawaz, MBBS⁹, Haris Latif, MD¹⁰, Fnu Poombal, MBBS, MD¹¹, Abu Hurairah, MD¹. P2892 - Outcomes of Liver Transplant in Patients With Budd-Chiari Syndrome: A Systematic Review and Meta-Analysis, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.