Transplantation reviews (Orlando, Fla.) · 2026
Use of aspirin for prevention of hepatic artery thrombosis after liver transplantation: A systematic review and meta-analysis.
СтатьяМетаанализСистематический обзорНазвание и аннотация: Перевод в очереди
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Ponte Raul Valério, Dos Santos Amanda Freitas Pompeu, de Lima Maria Fernanda Moura, de Lima Souza Priscila Ferreira, Sancio João Bernardo, Ernani Lucas, Soma Daiki, De Faria Werviston, Beduschi Thiago, de Mello Estrella Bianca
Аннотация
INTRODUCTION: Hepatic artery thrombosis (HAT) is a leading cause of graft loss after liver transplantation. While aspirin is used for prophylaxis, its benefit is debated due to potential bleeding risks. We performed a systematic review and meta-analysis to assess the efficacy and safety of aspirin prophylaxis in liver transplant recipients.
METHODS: We searched PubMed, Embase, and Cochrane Library for studies comparing aspirin prophylaxis to no aspirin. We computed risk ratios (RR) for binary outcomes, with 95% confidence intervals (CIs), and assessed heterogeneity using I2 statistics.
RESULTS: We included five studies with 4983 patients (2299 on aspirin). Aspirin significantly reduced HAT risk (RR 0.47; 95% CI: 0.24-0.94; p = 0.03) without increasing major bleeding risk (RR 0.81; 95% CI: 0.54-1.22; p = 0.31). Graft survival was higher in the aspirin group at 1 year (RR 1.06; p = 0.003) and 5 years (RR 1.06; p < 0.0001). Aspirin also reduced the incidence of acute cellular rejection at 1 year (RR 0.71; p = 0.03).
CONCLUSION: Our meta-analysis suggests that aspirin prophylaxis after liver transplantation may reduce the incidence of hepatic artery thrombosis, particularly among high-risk patients, without a significant increase in major bleeding events.
METHODS: We searched PubMed, Embase, and Cochrane Library for studies comparing aspirin prophylaxis to no aspirin. We computed risk ratios (RR) for binary outcomes, with 95% confidence intervals (CIs), and assessed heterogeneity using I2 statistics.
RESULTS: We included five studies with 4983 patients (2299 on aspirin). Aspirin significantly reduced HAT risk (RR 0.47; 95% CI: 0.24-0.94; p = 0.03) without increasing major bleeding risk (RR 0.81; 95% CI: 0.54-1.22; p = 0.31). Graft survival was higher in the aspirin group at 1 year (RR 1.06; p = 0.003) and 5 years (RR 1.06; p < 0.0001). Aspirin also reduced the incidence of acute cellular rejection at 1 year (RR 0.71; p = 0.03).
CONCLUSION: Our meta-analysis suggests that aspirin prophylaxis after liver transplantation may reduce the incidence of hepatic artery thrombosis, particularly among high-risk patients, without a significant increase in major bleeding events.