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Conducting a Literature Review
Benefits of conducting a literature review.
- Steps in Conducting a Literature Review
- Summary of the Process
- Additional Resources
- Literature Review Tutorial by American University Library
- The Literature Review: A Few Tips On Conducting It by University of Toronto
- Write a Literature Review by UC Santa Cruz University Library
While there might be many reasons for conducting a literature review, following are four key outcomes of doing the review.
Assessment of the current state of research on a topic . This is probably the most obvious value of the literature review. Once a researcher has determined an area to work with for a research project, a search of relevant information sources will help determine what is already known about the topic and how extensively the topic has already been researched.
Identification of the experts on a particular topic . One of the additional benefits derived from doing the literature review is that it will quickly reveal which researchers have written the most on a particular topic and are, therefore, probably the experts on the topic. Someone who has written twenty articles on a topic or on related topics is more than likely more knowledgeable than someone who has written a single article. This same writer will likely turn up as a reference in most of the other articles written on the same topic. From the number of articles written by the author and the number of times the writer has been cited by other authors, a researcher will be able to assume that the particular author is an expert in the area and, thus, a key resource for consultation in the current research to be undertaken.
Identification of key questions about a topic that need further research . In many cases a researcher may discover new angles that need further exploration by reviewing what has already been written on a topic. For example, research may suggest that listening to music while studying might lead to better retention of ideas, but the research might not have assessed whether a particular style of music is more beneficial than another. A researcher who is interested in pursuing this topic would then do well to follow up existing studies with a new study, based on previous research, that tries to identify which styles of music are most beneficial to retention.
Determination of methodologies used in past studies of the same or similar topics. It is often useful to review the types of studies that previous researchers have launched as a means of determining what approaches might be of most benefit in further developing a topic. By the same token, a review of previously conducted studies might lend itself to researchers determining a new angle for approaching research.
Upon completion of the literature review, a researcher should have a solid foundation of knowledge in the area and a good feel for the direction any new research should take. Should any additional questions arise during the course of the research, the researcher will know which experts to consult in order to quickly clear up those questions.
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Conducting a literature review: why do a literature review, why do a literature review.
- How To Find "The Literature"
- Found it -- Now What?
Besides the obvious reason for students -- because it is assigned! -- a literature review helps you explore the research that has come before you, to see how your research question has (or has not) already been addressed.
You identify:
- core research in the field
- experts in the subject area
- methodology you may want to use (or avoid)
- gaps in knowledge -- or where your research would fit in
It Also Helps You:
- Publish and share your findings
- Justify requests for grants and other funding
- Identify best practices to inform practice
- Set wider context for a program evaluation
- Compile information to support community organizing
Great brief overview, from NCSU
Want To Know More?
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- Last Updated: Apr 25, 2024 1:10 PM
- URL: https://guides.lib.berkeley.edu/litreview
- UConn Library
- Literature Review: The What, Why and How-to Guide
- Introduction
Literature Review: The What, Why and How-to Guide — Introduction
- Getting Started
- How to Pick a Topic
- Strategies to Find Sources
- Evaluating Sources & Lit. Reviews
- Tips for Writing Literature Reviews
- Writing Literature Review: Useful Sites
- Citation Resources
- Other Academic Writings
What are Literature Reviews?
So, what is a literature review? "A literature review is an account of what has been published on a topic by accredited scholars and researchers. In writing the literature review, your purpose is to convey to your reader what knowledge and ideas have been established on a topic, and what their strengths and weaknesses are. As a piece of writing, the literature review must be defined by a guiding concept (e.g., your research objective, the problem or issue you are discussing, or your argumentative thesis). It is not just a descriptive list of the material available, or a set of summaries." Taylor, D. The literature review: A few tips on conducting it . University of Toronto Health Sciences Writing Centre.
Goals of Literature Reviews
What are the goals of creating a Literature Review? A literature could be written to accomplish different aims:
- To develop a theory or evaluate an existing theory
- To summarize the historical or existing state of a research topic
- Identify a problem in a field of research
Baumeister, R. F., & Leary, M. R. (1997). Writing narrative literature reviews . Review of General Psychology , 1 (3), 311-320.
What kinds of sources require a Literature Review?
- A research paper assigned in a course
- A thesis or dissertation
- A grant proposal
- An article intended for publication in a journal
All these instances require you to collect what has been written about your research topic so that you can demonstrate how your own research sheds new light on the topic.
Types of Literature Reviews
What kinds of literature reviews are written?
Narrative review: The purpose of this type of review is to describe the current state of the research on a specific topic/research and to offer a critical analysis of the literature reviewed. Studies are grouped by research/theoretical categories, and themes and trends, strengths and weakness, and gaps are identified. The review ends with a conclusion section which summarizes the findings regarding the state of the research of the specific study, the gaps identify and if applicable, explains how the author's research will address gaps identify in the review and expand the knowledge on the topic reviewed.
- Example : Predictors and Outcomes of U.S. Quality Maternity Leave: A Review and Conceptual Framework: 10.1177/08948453211037398
Systematic review : "The authors of a systematic review use a specific procedure to search the research literature, select the studies to include in their review, and critically evaluate the studies they find." (p. 139). Nelson, L. K. (2013). Research in Communication Sciences and Disorders . Plural Publishing.
- Example : The effect of leave policies on increasing fertility: a systematic review: 10.1057/s41599-022-01270-w
Meta-analysis : "Meta-analysis is a method of reviewing research findings in a quantitative fashion by transforming the data from individual studies into what is called an effect size and then pooling and analyzing this information. The basic goal in meta-analysis is to explain why different outcomes have occurred in different studies." (p. 197). Roberts, M. C., & Ilardi, S. S. (2003). Handbook of Research Methods in Clinical Psychology . Blackwell Publishing.
- Example : Employment Instability and Fertility in Europe: A Meta-Analysis: 10.1215/00703370-9164737
Meta-synthesis : "Qualitative meta-synthesis is a type of qualitative study that uses as data the findings from other qualitative studies linked by the same or related topic." (p.312). Zimmer, L. (2006). Qualitative meta-synthesis: A question of dialoguing with texts . Journal of Advanced Nursing , 53 (3), 311-318.
- Example : Women’s perspectives on career successes and barriers: A qualitative meta-synthesis: 10.1177/05390184221113735
Literature Reviews in the Health Sciences
- UConn Health subject guide on systematic reviews Explanation of the different review types used in health sciences literature as well as tools to help you find the right review type
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Methodology
- How to Write a Literature Review | Guide, Examples, & Templates
How to Write a Literature Review | Guide, Examples, & Templates
Published on January 2, 2023 by Shona McCombes . Revised on September 11, 2023.
What is a literature review? A literature review is a survey of scholarly sources on a specific topic. It provides an overview of current knowledge, allowing you to identify relevant theories, methods, and gaps in the existing research that you can later apply to your paper, thesis, or dissertation topic .
There are five key steps to writing a literature review:
- Search for relevant literature
- Evaluate sources
- Identify themes, debates, and gaps
- Outline the structure
- Write your literature review
A good literature review doesn’t just summarize sources—it analyzes, synthesizes , and critically evaluates to give a clear picture of the state of knowledge on the subject.
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Table of contents
What is the purpose of a literature review, examples of literature reviews, step 1 – search for relevant literature, step 2 – evaluate and select sources, step 3 – identify themes, debates, and gaps, step 4 – outline your literature review’s structure, step 5 – write your literature review, free lecture slides, other interesting articles, frequently asked questions, introduction.
- Quick Run-through
- Step 1 & 2
When you write a thesis , dissertation , or research paper , you will likely have to conduct a literature review to situate your research within existing knowledge. The literature review gives you a chance to:
- Demonstrate your familiarity with the topic and its scholarly context
- Develop a theoretical framework and methodology for your research
- Position your work in relation to other researchers and theorists
- Show how your research addresses a gap or contributes to a debate
- Evaluate the current state of research and demonstrate your knowledge of the scholarly debates around your topic.
Writing literature reviews is a particularly important skill if you want to apply for graduate school or pursue a career in research. We’ve written a step-by-step guide that you can follow below.
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Writing literature reviews can be quite challenging! A good starting point could be to look at some examples, depending on what kind of literature review you’d like to write.
- Example literature review #1: “Why Do People Migrate? A Review of the Theoretical Literature” ( Theoretical literature review about the development of economic migration theory from the 1950s to today.)
- Example literature review #2: “Literature review as a research methodology: An overview and guidelines” ( Methodological literature review about interdisciplinary knowledge acquisition and production.)
- Example literature review #3: “The Use of Technology in English Language Learning: A Literature Review” ( Thematic literature review about the effects of technology on language acquisition.)
- Example literature review #4: “Learners’ Listening Comprehension Difficulties in English Language Learning: A Literature Review” ( Chronological literature review about how the concept of listening skills has changed over time.)
You can also check out our templates with literature review examples and sample outlines at the links below.
Download Word doc Download Google doc
Before you begin searching for literature, you need a clearly defined topic .
If you are writing the literature review section of a dissertation or research paper, you will search for literature related to your research problem and questions .
Make a list of keywords
Start by creating a list of keywords related to your research question. Include each of the key concepts or variables you’re interested in, and list any synonyms and related terms. You can add to this list as you discover new keywords in the process of your literature search.
- Social media, Facebook, Instagram, Twitter, Snapchat, TikTok
- Body image, self-perception, self-esteem, mental health
- Generation Z, teenagers, adolescents, youth
Search for relevant sources
Use your keywords to begin searching for sources. Some useful databases to search for journals and articles include:
- Your university’s library catalogue
- Google Scholar
- Project Muse (humanities and social sciences)
- Medline (life sciences and biomedicine)
- EconLit (economics)
- Inspec (physics, engineering and computer science)
You can also use boolean operators to help narrow down your search.
Make sure to read the abstract to find out whether an article is relevant to your question. When you find a useful book or article, you can check the bibliography to find other relevant sources.
You likely won’t be able to read absolutely everything that has been written on your topic, so it will be necessary to evaluate which sources are most relevant to your research question.
For each publication, ask yourself:
- What question or problem is the author addressing?
- What are the key concepts and how are they defined?
- What are the key theories, models, and methods?
- Does the research use established frameworks or take an innovative approach?
- What are the results and conclusions of the study?
- How does the publication relate to other literature in the field? Does it confirm, add to, or challenge established knowledge?
- What are the strengths and weaknesses of the research?
Make sure the sources you use are credible , and make sure you read any landmark studies and major theories in your field of research.
You can use our template to summarize and evaluate sources you’re thinking about using. Click on either button below to download.
Take notes and cite your sources
As you read, you should also begin the writing process. Take notes that you can later incorporate into the text of your literature review.
It is important to keep track of your sources with citations to avoid plagiarism . It can be helpful to make an annotated bibliography , where you compile full citation information and write a paragraph of summary and analysis for each source. This helps you remember what you read and saves time later in the process.
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To begin organizing your literature review’s argument and structure, be sure you understand the connections and relationships between the sources you’ve read. Based on your reading and notes, you can look for:
- Trends and patterns (in theory, method or results): do certain approaches become more or less popular over time?
- Themes: what questions or concepts recur across the literature?
- Debates, conflicts and contradictions: where do sources disagree?
- Pivotal publications: are there any influential theories or studies that changed the direction of the field?
- Gaps: what is missing from the literature? Are there weaknesses that need to be addressed?
This step will help you work out the structure of your literature review and (if applicable) show how your own research will contribute to existing knowledge.
- Most research has focused on young women.
- There is an increasing interest in the visual aspects of social media.
- But there is still a lack of robust research on highly visual platforms like Instagram and Snapchat—this is a gap that you could address in your own research.
There are various approaches to organizing the body of a literature review. Depending on the length of your literature review, you can combine several of these strategies (for example, your overall structure might be thematic, but each theme is discussed chronologically).
Chronological
The simplest approach is to trace the development of the topic over time. However, if you choose this strategy, be careful to avoid simply listing and summarizing sources in order.
Try to analyze patterns, turning points and key debates that have shaped the direction of the field. Give your interpretation of how and why certain developments occurred.
If you have found some recurring central themes, you can organize your literature review into subsections that address different aspects of the topic.
For example, if you are reviewing literature about inequalities in migrant health outcomes, key themes might include healthcare policy, language barriers, cultural attitudes, legal status, and economic access.
Methodological
If you draw your sources from different disciplines or fields that use a variety of research methods , you might want to compare the results and conclusions that emerge from different approaches. For example:
- Look at what results have emerged in qualitative versus quantitative research
- Discuss how the topic has been approached by empirical versus theoretical scholarship
- Divide the literature into sociological, historical, and cultural sources
Theoretical
A literature review is often the foundation for a theoretical framework . You can use it to discuss various theories, models, and definitions of key concepts.
You might argue for the relevance of a specific theoretical approach, or combine various theoretical concepts to create a framework for your research.
Like any other academic text , your literature review should have an introduction , a main body, and a conclusion . What you include in each depends on the objective of your literature review.
The introduction should clearly establish the focus and purpose of the literature review.
Depending on the length of your literature review, you might want to divide the body into subsections. You can use a subheading for each theme, time period, or methodological approach.
As you write, you can follow these tips:
- Summarize and synthesize: give an overview of the main points of each source and combine them into a coherent whole
- Analyze and interpret: don’t just paraphrase other researchers — add your own interpretations where possible, discussing the significance of findings in relation to the literature as a whole
- Critically evaluate: mention the strengths and weaknesses of your sources
- Write in well-structured paragraphs: use transition words and topic sentences to draw connections, comparisons and contrasts
In the conclusion, you should summarize the key findings you have taken from the literature and emphasize their significance.
When you’ve finished writing and revising your literature review, don’t forget to proofread thoroughly before submitting. Not a language expert? Check out Scribbr’s professional proofreading services !
This article has been adapted into lecture slides that you can use to teach your students about writing a literature review.
Scribbr slides are free to use, customize, and distribute for educational purposes.
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If you want to know more about the research process , methodology , research bias , or statistics , make sure to check out some of our other articles with explanations and examples.
- Sampling methods
- Simple random sampling
- Stratified sampling
- Cluster sampling
- Likert scales
- Reproducibility
Statistics
- Null hypothesis
- Statistical power
- Probability distribution
- Effect size
- Poisson distribution
Research bias
- Optimism bias
- Cognitive bias
- Implicit bias
- Hawthorne effect
- Anchoring bias
- Explicit bias
A literature review is a survey of scholarly sources (such as books, journal articles, and theses) related to a specific topic or research question .
It is often written as part of a thesis, dissertation , or research paper , in order to situate your work in relation to existing knowledge.
There are several reasons to conduct a literature review at the beginning of a research project:
- To familiarize yourself with the current state of knowledge on your topic
- To ensure that you’re not just repeating what others have already done
- To identify gaps in knowledge and unresolved problems that your research can address
- To develop your theoretical framework and methodology
- To provide an overview of the key findings and debates on the topic
Writing the literature review shows your reader how your work relates to existing research and what new insights it will contribute.
The literature review usually comes near the beginning of your thesis or dissertation . After the introduction , it grounds your research in a scholarly field and leads directly to your theoretical framework or methodology .
A literature review is a survey of credible sources on a topic, often used in dissertations , theses, and research papers . Literature reviews give an overview of knowledge on a subject, helping you identify relevant theories and methods, as well as gaps in existing research. Literature reviews are set up similarly to other academic texts , with an introduction , a main body, and a conclusion .
An annotated bibliography is a list of source references that has a short description (called an annotation ) for each of the sources. It is often assigned as part of the research process for a paper .
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Introduction to Literature Reviews
Introduction.
- Step One: Define
- Step Two: Research
- Step Three: Write
- Suggested Readings
A literature review is a written work that :
- Compiles significant research published on a topic by accredited scholars and researchers;
- Surveys scholarly articles, books, dissertations, conference proceedings, and other sources;
- Examines contrasting perspectives, theoretical approaches, methodologies, findings, results, conclusions.
- Reviews critically, analyzes, and synthesizes existing research on a topic; and,
- Performs a thorough “re” view, “overview”, or “look again” of past and current works on a subject, issue, or theory.
From these analyses, the writer then offers an overview of the current status of a particular area of knowledge from both a practical and theoretical perspective.
Literature reviews are important because they are usually a required step in a thesis proposal (Master's or PhD). The proposal will not be well-supported without a literature review. Also, literature reviews are important because they help you learn important authors and ideas in your field. This is useful for your coursework and your writing. Knowing key authors also helps you become acquainted with other researchers in your field.
Look at this diagram and imagine that your research is the "something new." This shows how your research should relate to major works and other sources.
Olivia Whitfield | Graduate Reference Assistant | 2012-2015
- Next: Step One: Define >>
- Last Updated: Aug 29, 2024 1:55 PM
- URL: https://libraryguides.missouri.edu/literaturereview
Libraries | Research Guides
Literature reviews, what is a literature review, learning more about how to do a literature review.
- Planning the Review
- The Research Question
- Choosing Where to Search
- Organizing the Review
- Writing the Review
A literature review is a review and synthesis of existing research on a topic or research question. A literature review is meant to analyze the scholarly literature, make connections across writings and identify strengths, weaknesses, trends, and missing conversations. A literature review should address different aspects of a topic as it relates to your research question. A literature review goes beyond a description or summary of the literature you have read.
- Sage Research Methods Core This link opens in a new window SAGE Research Methods supports research at all levels by providing material to guide users through every step of the research process. SAGE Research Methods is the ultimate methods library with more than 1000 books, reference works, journal articles, and instructional videos by world-leading academics from across the social sciences, including the largest collection of qualitative methods books available online from any scholarly publisher. – Publisher
- Next: Planning the Review >>
- Last Updated: Jul 8, 2024 11:22 AM
- URL: https://libguides.northwestern.edu/literaturereviews
Literature Review
The purpose of a literature review is to collect relevant, timely research on your chosen topic, and synthesize it into a cohesive summary of existing knowledge in the field. This then prepares you for making your own argument on that topic, or for conducting your own original research.
Depending on your field of study, literature reviews can take different forms. Some disciplines require that you synthesize your sources topically, organizing your paragraphs according to how your different sources discuss similar topics. Other disciplines require that you discuss each source in individual paragraphs, covering various aspects in that single article, chapter, or book.
Within your review of a given source, you can cover many different aspects, including (if a research study) the purpose, scope, methods, results, any discussion points, limitations, and implications for future research. Make sure you know which model your professor expects you to follow when writing your own literature reviews.
Tip : Literature reviews may or may not be a graded component of your class or major assignment, but even if it is not, it is a good idea to draft one so that you know the current conversations taking place on your chosen topic. It can better prepare you to write your own, unique argument.
Benefits of Literature Reviews
- Literature reviews allow you to gain familiarity with the current knowledge in your chosen field, as well as the boundaries and limitations of that field.
- Literature reviews also help you to gain an understanding of the theory(ies) driving the field, allowing you to place your research question into context.
- Literature reviews provide an opportunity for you to see and even evaluate successful and unsuccessful assessment and research methods in your field.
- Literature reviews prevent you from duplicating the same information as others writing in your field, allowing you to find your own, unique approach to your topic.
- Literature reviews give you familiarity with the knowledge in your field, giving you the chance to analyze the significance of your additional research.
Choosing Your Sources
When selecting your sources to compile your literature review, make sure you follow these guidelines to ensure you are working with the strongest, most appropriate sources possible.
Topically Relevant
Find sources within the scope of your topic
Appropriately Aged
Find sources that are not too old for your assignment
Find sources whose authors have authority on your topic
Appropriately “Published”
Find sources that meet your instructor’s guidelines (academic, professional, print, etc.)
Tip: Treat your professors and librarians as experts you can turn to for advice on how to locate sources. They are a valuable asset to you, so take advantage of them!
Organizing Your Literature Review
Synthesizing topically.
Some assignments require discussing your sources together, in paragraphs organized according to shared topics between them.
For example, in a literature review covering current conversations on Alison Bechdel’s Fun Home , authors may discuss various topics including:
- her graphic style
- her allusions to various literary texts
- her story’s implications regarding LGBT experiences in 20 th century America.
In this case, you would cluster your sources on these three topics. One paragraph would cover how the sources you collected dealt with Bechdel’s graphic style. Another, her allusions. A third, her implications.
Each of these paragraphs would discuss how the sources you found treated these topics in connection to one another. Basically, you compare and contrast how your sources discuss similar issues and points.
To determine these shared topics, examine aspects including:
- Definition of terms
- Common ground
- Issues that divide
- Rhetorical context
Summarizing Individually
Depending on the assignment, your professor may prefer that you discuss each source in your literature review individually (in their own, separate paragraphs or sections). Your professor may give you specific guidelines as far as what to cover in these paragraphs/sections.
If, for instance, your sources are all primary research studies, here are some aspects to consider covering:
- Participants
- Limitations
- Implications
- Significance
Each section of your literature review, in this case, will identify all of these elements for each individual article.
You may or may not need to separate your information into multiple paragraphs for each source. If you do, using proper headings in the appropriate citation style (APA, MLA, etc.) will help keep you organized.
If you are writing a literature review as part of a larger assignment, you generally do not need an introduction and/or conclusion, because it is embedded within the context of your larger paper.
If, however, your literature review is a standalone assignment, it is a good idea to include some sort of introduction and conclusion to provide your reader with context regarding your topic, purpose, and any relevant implications or further questions. Make sure you know what your professor is expecting for your literature review’s content.
Typically, a literature review concludes with a full bibliography of your included sources. Make sure you use the style guide required by your professor for this assignment.
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Literature Reviews
- What is a literature review?
- Steps in the Literature Review Process
- Define your research question
- Determine inclusion and exclusion criteria
- Choose databases and search
- Review Results
- Synthesize Results
- Analyze Results
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What is a Literature Review?
A literature or narrative review is a comprehensive review and analysis of the published literature on a specific topic or research question. The literature that is reviewed contains: books, articles, academic articles, conference proceedings, association papers, and dissertations. It contains the most pertinent studies and points to important past and current research and practices. It provides background and context, and shows how your research will contribute to the field.
A literature review should:
- Provide a comprehensive and updated review of the literature;
- Explain why this review has taken place;
- Articulate a position or hypothesis;
- Acknowledge and account for conflicting and corroborating points of view
From S age Research Methods
Purpose of a Literature Review
A literature review can be written as an introduction to a study to:
- Demonstrate how a study fills a gap in research
- Compare a study with other research that's been done
Or it can be a separate work (a research article on its own) which:
- Organizes or describes a topic
- Describes variables within a particular issue/problem
Limitations of a Literature Review
Some of the limitations of a literature review are:
- It's a snapshot in time. Unlike other reviews, this one has beginning, a middle and an end. There may be future developments that could make your work less relevant.
- It may be too focused. Some niche studies may miss the bigger picture.
- It can be difficult to be comprehensive. There is no way to make sure all the literature on a topic was considered.
- It is easy to be biased if you stick to top tier journals. There may be other places where people are publishing exemplary research. Look to open access publications and conferences to reflect a more inclusive collection. Also, make sure to include opposing views (and not just supporting evidence).
Source: Grant, Maria J., and Andrew Booth. “A Typology of Reviews: An Analysis of 14 Review Types and Associated Methodologies.” Health Information & Libraries Journal, vol. 26, no. 2, June 2009, pp. 91–108. Wiley Online Library, doi:10.1111/j.1471-1842.2009.00848.x.
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Literature Review – Types Writing Guide and Examples
Table of Contents
Literature Review
Definition:
A literature review is a comprehensive and critical analysis of the existing literature on a particular topic or research question. It involves identifying, evaluating, and synthesizing relevant literature, including scholarly articles, books, and other sources, to provide a summary and critical assessment of what is known about the topic.
Types of Literature Review
Types of Literature Review are as follows:
- Narrative literature review : This type of review involves a comprehensive summary and critical analysis of the available literature on a particular topic or research question. It is often used as an introductory section of a research paper.
- Systematic literature review: This is a rigorous and structured review that follows a pre-defined protocol to identify, evaluate, and synthesize all relevant studies on a specific research question. It is often used in evidence-based practice and systematic reviews.
- Meta-analysis: This is a quantitative review that uses statistical methods to combine data from multiple studies to derive a summary effect size. It provides a more precise estimate of the overall effect than any individual study.
- Scoping review: This is a preliminary review that aims to map the existing literature on a broad topic area to identify research gaps and areas for further investigation.
- Critical literature review : This type of review evaluates the strengths and weaknesses of the existing literature on a particular topic or research question. It aims to provide a critical analysis of the literature and identify areas where further research is needed.
- Conceptual literature review: This review synthesizes and integrates theories and concepts from multiple sources to provide a new perspective on a particular topic. It aims to provide a theoretical framework for understanding a particular research question.
- Rapid literature review: This is a quick review that provides a snapshot of the current state of knowledge on a specific research question or topic. It is often used when time and resources are limited.
- Thematic literature review : This review identifies and analyzes common themes and patterns across a body of literature on a particular topic. It aims to provide a comprehensive overview of the literature and identify key themes and concepts.
- Realist literature review: This review is often used in social science research and aims to identify how and why certain interventions work in certain contexts. It takes into account the context and complexities of real-world situations.
- State-of-the-art literature review : This type of review provides an overview of the current state of knowledge in a particular field, highlighting the most recent and relevant research. It is often used in fields where knowledge is rapidly evolving, such as technology or medicine.
- Integrative literature review: This type of review synthesizes and integrates findings from multiple studies on a particular topic to identify patterns, themes, and gaps in the literature. It aims to provide a comprehensive understanding of the current state of knowledge on a particular topic.
- Umbrella literature review : This review is used to provide a broad overview of a large and diverse body of literature on a particular topic. It aims to identify common themes and patterns across different areas of research.
- Historical literature review: This type of review examines the historical development of research on a particular topic or research question. It aims to provide a historical context for understanding the current state of knowledge on a particular topic.
- Problem-oriented literature review : This review focuses on a specific problem or issue and examines the literature to identify potential solutions or interventions. It aims to provide practical recommendations for addressing a particular problem or issue.
- Mixed-methods literature review : This type of review combines quantitative and qualitative methods to synthesize and analyze the available literature on a particular topic. It aims to provide a more comprehensive understanding of the research question by combining different types of evidence.
Parts of Literature Review
Parts of a literature review are as follows:
Introduction
The introduction of a literature review typically provides background information on the research topic and why it is important. It outlines the objectives of the review, the research question or hypothesis, and the scope of the review.
Literature Search
This section outlines the search strategy and databases used to identify relevant literature. The search terms used, inclusion and exclusion criteria, and any limitations of the search are described.
Literature Analysis
The literature analysis is the main body of the literature review. This section summarizes and synthesizes the literature that is relevant to the research question or hypothesis. The review should be organized thematically, chronologically, or by methodology, depending on the research objectives.
Critical Evaluation
Critical evaluation involves assessing the quality and validity of the literature. This includes evaluating the reliability and validity of the studies reviewed, the methodology used, and the strength of the evidence.
The conclusion of the literature review should summarize the main findings, identify any gaps in the literature, and suggest areas for future research. It should also reiterate the importance of the research question or hypothesis and the contribution of the literature review to the overall research project.
The references list includes all the sources cited in the literature review, and follows a specific referencing style (e.g., APA, MLA, Harvard).
How to write Literature Review
Here are some steps to follow when writing a literature review:
- Define your research question or topic : Before starting your literature review, it is essential to define your research question or topic. This will help you identify relevant literature and determine the scope of your review.
- Conduct a comprehensive search: Use databases and search engines to find relevant literature. Look for peer-reviewed articles, books, and other academic sources that are relevant to your research question or topic.
- Evaluate the sources: Once you have found potential sources, evaluate them critically to determine their relevance, credibility, and quality. Look for recent publications, reputable authors, and reliable sources of data and evidence.
- Organize your sources: Group the sources by theme, method, or research question. This will help you identify similarities and differences among the literature, and provide a structure for your literature review.
- Analyze and synthesize the literature : Analyze each source in depth, identifying the key findings, methodologies, and conclusions. Then, synthesize the information from the sources, identifying patterns and themes in the literature.
- Write the literature review : Start with an introduction that provides an overview of the topic and the purpose of the literature review. Then, organize the literature according to your chosen structure, and analyze and synthesize the sources. Finally, provide a conclusion that summarizes the key findings of the literature review, identifies gaps in knowledge, and suggests areas for future research.
- Edit and proofread: Once you have written your literature review, edit and proofread it carefully to ensure that it is well-organized, clear, and concise.
Examples of Literature Review
Here’s an example of how a literature review can be conducted for a thesis on the topic of “ The Impact of Social Media on Teenagers’ Mental Health”:
- Start by identifying the key terms related to your research topic. In this case, the key terms are “social media,” “teenagers,” and “mental health.”
- Use academic databases like Google Scholar, JSTOR, or PubMed to search for relevant articles, books, and other publications. Use these keywords in your search to narrow down your results.
- Evaluate the sources you find to determine if they are relevant to your research question. You may want to consider the publication date, author’s credentials, and the journal or book publisher.
- Begin reading and taking notes on each source, paying attention to key findings, methodologies used, and any gaps in the research.
- Organize your findings into themes or categories. For example, you might categorize your sources into those that examine the impact of social media on self-esteem, those that explore the effects of cyberbullying, and those that investigate the relationship between social media use and depression.
- Synthesize your findings by summarizing the key themes and highlighting any gaps or inconsistencies in the research. Identify areas where further research is needed.
- Use your literature review to inform your research questions and hypotheses for your thesis.
For example, after conducting a literature review on the impact of social media on teenagers’ mental health, a thesis might look like this:
“Using a mixed-methods approach, this study aims to investigate the relationship between social media use and mental health outcomes in teenagers. Specifically, the study will examine the effects of cyberbullying, social comparison, and excessive social media use on self-esteem, anxiety, and depression. Through an analysis of survey data and qualitative interviews with teenagers, the study will provide insight into the complex relationship between social media use and mental health outcomes, and identify strategies for promoting positive mental health outcomes in young people.”
Reference: Smith, J., Jones, M., & Lee, S. (2019). The effects of social media use on adolescent mental health: A systematic review. Journal of Adolescent Health, 65(2), 154-165. doi:10.1016/j.jadohealth.2019.03.024
Reference Example: Author, A. A., Author, B. B., & Author, C. C. (Year). Title of article. Title of Journal, volume number(issue number), page range. doi:0000000/000000000000 or URL
Applications of Literature Review
some applications of literature review in different fields:
- Social Sciences: In social sciences, literature reviews are used to identify gaps in existing research, to develop research questions, and to provide a theoretical framework for research. Literature reviews are commonly used in fields such as sociology, psychology, anthropology, and political science.
- Natural Sciences: In natural sciences, literature reviews are used to summarize and evaluate the current state of knowledge in a particular field or subfield. Literature reviews can help researchers identify areas where more research is needed and provide insights into the latest developments in a particular field. Fields such as biology, chemistry, and physics commonly use literature reviews.
- Health Sciences: In health sciences, literature reviews are used to evaluate the effectiveness of treatments, identify best practices, and determine areas where more research is needed. Literature reviews are commonly used in fields such as medicine, nursing, and public health.
- Humanities: In humanities, literature reviews are used to identify gaps in existing knowledge, develop new interpretations of texts or cultural artifacts, and provide a theoretical framework for research. Literature reviews are commonly used in fields such as history, literary studies, and philosophy.
Role of Literature Review in Research
Here are some applications of literature review in research:
- Identifying Research Gaps : Literature review helps researchers identify gaps in existing research and literature related to their research question. This allows them to develop new research questions and hypotheses to fill those gaps.
- Developing Theoretical Framework: Literature review helps researchers develop a theoretical framework for their research. By analyzing and synthesizing existing literature, researchers can identify the key concepts, theories, and models that are relevant to their research.
- Selecting Research Methods : Literature review helps researchers select appropriate research methods and techniques based on previous research. It also helps researchers to identify potential biases or limitations of certain methods and techniques.
- Data Collection and Analysis: Literature review helps researchers in data collection and analysis by providing a foundation for the development of data collection instruments and methods. It also helps researchers to identify relevant data sources and identify potential data analysis techniques.
- Communicating Results: Literature review helps researchers to communicate their results effectively by providing a context for their research. It also helps to justify the significance of their findings in relation to existing research and literature.
Purpose of Literature Review
Some of the specific purposes of a literature review are as follows:
- To provide context: A literature review helps to provide context for your research by situating it within the broader body of literature on the topic.
- To identify gaps and inconsistencies: A literature review helps to identify areas where further research is needed or where there are inconsistencies in the existing literature.
- To synthesize information: A literature review helps to synthesize the information from multiple sources and present a coherent and comprehensive picture of the current state of knowledge on the topic.
- To identify key concepts and theories : A literature review helps to identify key concepts and theories that are relevant to your research question and provide a theoretical framework for your study.
- To inform research design: A literature review can inform the design of your research study by identifying appropriate research methods, data sources, and research questions.
Characteristics of Literature Review
Some Characteristics of Literature Review are as follows:
- Identifying gaps in knowledge: A literature review helps to identify gaps in the existing knowledge and research on a specific topic or research question. By analyzing and synthesizing the literature, you can identify areas where further research is needed and where new insights can be gained.
- Establishing the significance of your research: A literature review helps to establish the significance of your own research by placing it in the context of existing research. By demonstrating the relevance of your research to the existing literature, you can establish its importance and value.
- Informing research design and methodology : A literature review helps to inform research design and methodology by identifying the most appropriate research methods, techniques, and instruments. By reviewing the literature, you can identify the strengths and limitations of different research methods and techniques, and select the most appropriate ones for your own research.
- Supporting arguments and claims: A literature review provides evidence to support arguments and claims made in academic writing. By citing and analyzing the literature, you can provide a solid foundation for your own arguments and claims.
- I dentifying potential collaborators and mentors: A literature review can help identify potential collaborators and mentors by identifying researchers and practitioners who are working on related topics or using similar methods. By building relationships with these individuals, you can gain valuable insights and support for your own research and practice.
- Keeping up-to-date with the latest research : A literature review helps to keep you up-to-date with the latest research on a specific topic or research question. By regularly reviewing the literature, you can stay informed about the latest findings and developments in your field.
Advantages of Literature Review
There are several advantages to conducting a literature review as part of a research project, including:
- Establishing the significance of the research : A literature review helps to establish the significance of the research by demonstrating the gap or problem in the existing literature that the study aims to address.
- Identifying key concepts and theories: A literature review can help to identify key concepts and theories that are relevant to the research question, and provide a theoretical framework for the study.
- Supporting the research methodology : A literature review can inform the research methodology by identifying appropriate research methods, data sources, and research questions.
- Providing a comprehensive overview of the literature : A literature review provides a comprehensive overview of the current state of knowledge on a topic, allowing the researcher to identify key themes, debates, and areas of agreement or disagreement.
- Identifying potential research questions: A literature review can help to identify potential research questions and areas for further investigation.
- Avoiding duplication of research: A literature review can help to avoid duplication of research by identifying what has already been done on a topic, and what remains to be done.
- Enhancing the credibility of the research : A literature review helps to enhance the credibility of the research by demonstrating the researcher’s knowledge of the existing literature and their ability to situate their research within a broader context.
Limitations of Literature Review
Limitations of Literature Review are as follows:
- Limited scope : Literature reviews can only cover the existing literature on a particular topic, which may be limited in scope or depth.
- Publication bias : Literature reviews may be influenced by publication bias, which occurs when researchers are more likely to publish positive results than negative ones. This can lead to an incomplete or biased picture of the literature.
- Quality of sources : The quality of the literature reviewed can vary widely, and not all sources may be reliable or valid.
- Time-limited: Literature reviews can become quickly outdated as new research is published, making it difficult to keep up with the latest developments in a field.
- Subjective interpretation : Literature reviews can be subjective, and the interpretation of the findings can vary depending on the researcher’s perspective or bias.
- Lack of original data : Literature reviews do not generate new data, but rather rely on the analysis of existing studies.
- Risk of plagiarism: It is important to ensure that literature reviews do not inadvertently contain plagiarism, which can occur when researchers use the work of others without proper attribution.
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The advantage of literature reviews for evidence-based practice
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The Systematic Literature Review: Advantages and Applications in Nonprofit Scholarship
- Research Papers
- Published: 28 September 2021
- Volume 33 , pages 1256–1262, ( 2022 )
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- Beth Gazley ORCID: orcid.org/0000-0002-7352-4476 1
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Voluntary and nonprofit sector studies are relatively young and still seeking common intellectual ground. One vehicle for accomplishing this task is the systematic literature review (SLR). SLRs approach knowledge generation through a rules-driven comprehensive process for finding and analyzing prior knowledge. SLRs support the voluntary sector’s current emphasis on data transparency in publication. They also support the growth of voluntary sector empiricism by offering a greater claim to reliability and generalizability of findings. Finally, they support goals of inclusiveness and knowledge unification that are important to the voluntary sector academy, its funders, and its constituents. This explanatory article draws on examples from the nonprofit and voluntary sector to describe the rationale and methods of the SLR.
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There is no data, therefore the data-sharing statement is not applicable.
For more on publication bias, see https://methods.cochrane.org/bias/reporting-biases .
Grey literature is industry and government publications outside of academic and commercial publishing channels. They are commonly considered a legitimate element of SLRs. For more, see www.greylit.org .
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Writing an effective literature review
Lorelei lingard.
Schulich School of Medicine & Dentistry, Health Sciences Addition, Western University, London, Ontario Canada
In the Writer’s Craft section we offer simple tips to improve your writing in one of three areas: Energy, Clarity and Persuasiveness. Each entry focuses on a key writing feature or strategy, illustrates how it commonly goes wrong, teaches the grammatical underpinnings necessary to understand it and offers suggestions to wield it effectively. We encourage readers to share comments on or suggestions for this section on Twitter, using the hashtag: #how’syourwriting?
This Writer’s Craft instalment is the first in a two-part series that offers strategies for effectively presenting the literature review section of a research manuscript. This piece alerts writers to the importance of not only summarizing what is known but also identifying precisely what is not, in order to explicitly signal the relevance of their research. In this instalment, I will introduce readers to the mapping the gap metaphor, the knowledge claims heuristic, and the need to characterize the gap.
Mapping the gap
The purpose of the literature review section of a manuscript is not to report what is known about your topic. The purpose is to identify what remains unknown— what academic writing scholar Janet Giltrow has called the ‘knowledge deficit’ — thus establishing the need for your research study [ 1 ]. In an earlier Writer’s Craft instalment, the Problem-Gap-Hook heuristic was introduced as a way of opening your paper with a clear statement of the problem that your work grapples with, the gap in our current knowledge about that problem, and the reason the gap matters [ 2 ]. This article explains how to use the literature review section of your paper to build and characterize the Gap claim in your Problem-Gap-Hook. The metaphor of ‘mapping the gap’ is a way of thinking about how to select and arrange your review of the existing literature so that readers can recognize why your research needed to be done, and why its results constitute a meaningful advance on what was already known about the topic.
Many writers have learned that the literature review should describe what is known. The trouble with this approach is that it can produce a laundry list of facts-in-the-world that does not persuade the reader that the current study is a necessary next step. Instead, think of your literature review as painting in a map of your research domain: as you review existing knowledge, you are painting in sections of the map, but your goal is not to end with the whole map fully painted. That would mean there is nothing more we need to know about the topic, and that leaves no room for your research. What you want to end up with is a map in which painted sections surround and emphasize a white space, a gap in what is known that matters. Conceptualizing your literature review this way helps to ensure that it achieves its dual goal: of presenting what is known and pointing out what is not—the latter of these goals is necessary for your literature review to establish the necessity and importance of the research you are about to describe in the methods section which will immediately follow the literature review.
To a novice researcher or graduate student, this may seem counterintuitive. Hopefully you have invested significant time in reading the existing literature, and you are understandably keen to demonstrate that you’ve read everything ever published about your topic! Be careful, though, not to use the literature review section to regurgitate all of your reading in manuscript form. For one thing, it creates a laundry list of facts that makes for horrible reading. But there are three other reasons for avoiding this approach. First, you don’t have the space. In published medical education research papers, the literature review is quite short, ranging from a few paragraphs to a few pages, so you can’t summarize everything you’ve read. Second, you’re preaching to the converted. If you approach your paper as a contribution to an ongoing scholarly conversation,[ 2 ] then your literature review should summarize just the aspects of that conversation that are required to situate your conversational turn as informed and relevant. Third, the key to relevance is to point to a gap in what is known. To do so, you summarize what is known for the express purpose of identifying what is not known . Seen this way, the literature review should exert a gravitational pull on the reader, leading them inexorably to the white space on the map of knowledge you’ve painted for them. That white space is the space that your research fills.
Knowledge claims
To help writers move beyond the laundry list, the notion of ‘knowledge claims’ can be useful. A knowledge claim is a way of presenting the growing understanding of the community of researchers who have been exploring your topic. These are not disembodied facts, but rather incremental insights that some in the field may agree with and some may not, depending on their different methodological and disciplinary approaches to the topic. Treating the literature review as a story of the knowledge claims being made by researchers in the field can help writers with one of the most sophisticated aspects of a literature review—locating the knowledge being reviewed. Where does it come from? What is debated? How do different methodologies influence the knowledge being accumulated? And so on.
Consider this example of the knowledge claims (KC), Gap and Hook for the literature review section of a research paper on distributed healthcare teamwork:
KC: We know that poor team communication can cause errors. KC: And we know that team training can be effective in improving team communication. KC: This knowledge has prompted a push to incorporate teamwork training principles into health professions education curricula. KC: However, most of what we know about team training research has come from research with co-located teams—i. e., teams whose members work together in time and space. Gap: Little is known about how teamwork training principles would apply in distributed teams, whose members work asynchronously and are spread across different locations. Hook: Given that much healthcare teamwork is distributed rather than co-located, our curricula will be severely lacking until we create refined teamwork training principles that reflect distributed as well as co-located work contexts.
The ‘We know that …’ structure illustrated in this example is a template for helping you draft and organize. In your final version, your knowledge claims will be expressed with more sophistication. For instance, ‘We know that poor team communication can cause errors’ will become something like ‘Over a decade of patient safety research has demonstrated that poor team communication is the dominant cause of medical errors.’ This simple template of knowledge claims, though, provides an outline for the paragraphs in your literature review, each of which will provide detailed evidence to illustrate a knowledge claim. Using this approach, the order of the paragraphs in the literature review is strategic and persuasive, leading the reader to the gap claim that positions the relevance of the current study. To expand your vocabulary for creating such knowledge claims, linking them logically and positioning yourself amid them, I highly recommend Graff and Birkenstein’s little handbook of ‘templates’ [ 3 ].
As you organize your knowledge claims, you will also want to consider whether you are trying to map the gap in a well-studied field, or a relatively understudied one. The rhetorical challenge is different in each case. In a well-studied field, like professionalism in medical education, you must make a strong, explicit case for the existence of a gap. Readers may come to your paper tired of hearing about this topic and tempted to think we can’t possibly need more knowledge about it. Listing the knowledge claims can help you organize them most effectively and determine which pieces of knowledge may be unnecessary to map the white space your research attempts to fill. This does not mean that you leave out relevant information: your literature review must still be accurate. But, since you will not be able to include everything, selecting carefully among the possible knowledge claims is essential to producing a coherent, well-argued literature review.
Characterizing the gap
Once you’ve identified the gap, your literature review must characterize it. What kind of gap have you found? There are many ways to characterize a gap, but some of the more common include:
- a pure knowledge deficit—‘no one has looked at the relationship between longitudinal integrated clerkships and medical student abuse’
- a shortcoming in the scholarship, often due to philosophical or methodological tendencies and oversights—‘scholars have interpreted x from a cognitivist perspective, but ignored the humanist perspective’ or ‘to date, we have surveyed the frequency of medical errors committed by residents, but we have not explored their subjective experience of such errors’
- a controversy—‘scholars disagree on the definition of professionalism in medicine …’
- a pervasive and unproven assumption—‘the theme of technological heroism—technology will solve what ails teamwork—is ubiquitous in the literature, but what is that belief based on?’
To characterize the kind of gap, you need to know the literature thoroughly. That means more than understanding each paper individually; you also need to be placing each paper in relation to others. This may require changing your note-taking technique while you’re reading; take notes on what each paper contributes to knowledge, but also on how it relates to other papers you’ve read, and what it suggests about the kind of gap that is emerging.
In summary, think of your literature review as mapping the gap rather than simply summarizing the known. And pay attention to characterizing the kind of gap you’ve mapped. This strategy can help to make your literature review into a compelling argument rather than a list of facts. It can remind you of the danger of describing so fully what is known that the reader is left with the sense that there is no pressing need to know more. And it can help you to establish a coherence between the kind of gap you’ve identified and the study methodology you will use to fill it.
Acknowledgements
Thanks to Mark Goldszmidt for his feedback on an early version of this manuscript.
PhD, is director of the Centre for Education Research & Innovation at Schulich School of Medicine & Dentistry, and professor for the Department of Medicine at Western University in London, Ontario, Canada.
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- Literature Review Guidelines
Making sense of what has been written on your topic.
Goals of a literature review:.
Before doing work in primary sources, historians must know what has been written on their topic. They must be familiar with theories and arguments–as well as facts–that appear in secondary sources.
Before you proceed with your research project, you too must be familiar with the literature: you do not want to waste time on theories that others have disproved and you want to take full advantage of what others have argued. You want to be able to discuss and analyze your topic.
Your literature review will demonstrate your familiarity with your topic’s secondary literature.
GUIDELINES FOR A LITERATURE REVIEW:
1) LENGTH: 8-10 pages of text for Senior Theses (485) (consult with your professor for other classes), with either footnotes or endnotes and with a works-consulted bibliography. [See also the citation guide on this site.]
2) NUMBER OF WORKS REVIEWED: Depends on the assignment, but for Senior Theses (485), at least ten is typical.
3) CHOOSING WORKS:
Your literature review must include enough works to provide evidence of both the breadth and the depth of the research on your topic or, at least, one important angle of it. The number of works necessary to do this will depend on your topic. For most topics, AT LEAST TEN works (mostly books but also significant scholarly articles) are necessary, although you will not necessarily give all of them equal treatment in your paper (e.g., some might appear in notes rather than the essay). 4) ORGANIZING/ARRANGING THE LITERATURE:
As you uncover the literature (i.e., secondary writing) on your topic, you should determine how the various pieces relate to each other. Your ability to do so will demonstrate your understanding of the evolution of literature.
You might determine that the literature makes sense when divided by time period, by methodology, by sources, by discipline, by thematic focus, by race, ethnicity, and/or gender of author, or by political ideology. This list is not exhaustive. You might also decide to subdivide categories based on other criteria. There is no “rule” on divisions—historians wrote the literature without consulting each other and without regard to the goal of fitting into a neat, obvious organization useful to students.
The key step is to FIGURE OUT the most logical, clarifying angle. Do not arbitrarily choose a categorization; use the one that the literature seems to fall into. How do you do that? For every source, you should note its thesis, date, author background, methodology, and sources. Does a pattern appear when you consider such information from each of your sources? If so, you have a possible thesis about the literature. If not, you might still have a thesis.
Consider: Are there missing elements in the literature? For example, no works published during a particular (usually fairly lengthy) time period? Or do studies appear after long neglect of a topic? Do interpretations change at some point? Does the major methodology being used change? Do interpretations vary based on sources used?
Follow these links for more help on analyzing historiography and historical perspective .
5) CONTENTS OF LITERATURE REVIEW:
The literature review is a research paper with three ingredients:
a) A brief discussion of the issue (the person, event, idea). [While this section should be brief, it needs to set up the thesis and literature that follow.] b) Your thesis about the literature c) A clear argument, using the works on topic as evidence, i.e., you discuss the sources in relation to your thesis, not as a separate topic.
These ingredients must be presented in an essay with an introduction, body, and conclusion.
6) ARGUING YOUR THESIS:
The thesis of a literature review should not only describe how the literature has evolved, but also provide a clear evaluation of that literature. You should assess the literature in terms of the quality of either individual works or categories of works. For instance, you might argue that a certain approach (e.g. social history, cultural history, or another) is better because it deals with a more complex view of the issue or because they use a wider array of source materials more effectively. You should also ensure that you integrate that evaluation throughout your argument. Doing so might include negative assessments of some works in order to reinforce your argument regarding the positive qualities of other works and approaches to the topic.
Within each group, you should provide essential information about each work: the author’s thesis, the work’s title and date, the author’s supporting arguments and major evidence.
In most cases, arranging the sources chronologically by publication date within each section makes the most sense because earlier works influenced later ones in one way or another. Reference to publication date also indicates that you are aware of this significant historiographical element.
As you discuss each work, DO NOT FORGET WHY YOU ARE DISCUSSING IT. YOU ARE PRESENTING AND SUPPORTING A THESIS ABOUT THE LITERATURE.
When discussing a particular work for the first time, you should refer to it by the author’s full name, the work’s title, and year of publication (either in parentheses after the title or worked into the sentence).
For example, “The field of slavery studies has recently been transformed by Ben Johnson’s The New Slave (2001)” and “Joe Doe argues in his 1997 study, Slavery in America, that . . . .”
Your paper should always note secondary sources’ relationship to each other, particularly in terms of your thesis about the literature (e.g., “Unlike Smith’s work, Mary Brown’s analysis reaches the conclusion that . . . .” and “Because of Anderson’s reliance on the president’s personal papers, his interpretation differs from Barry’s”). The various pieces of the literature are “related” to each other, so you need to indicate to the reader some of that relationship. (It helps the reader follow your thesis, and it convinces the reader that you know what you are talking about.)
7) DOCUMENTATION:
Each source you discuss in your paper must be documented using footnotes/endnotes and a bibliography. Providing author and title and date in the paper is not sufficient. Use correct Turabian/Chicago Manual of Style form. [See Bibliography and Footnotes/Endnotes pages.]
In addition, further supporting, but less significant, sources should be included in content foot or endnotes . (e.g., “For a similar argument to Ben Johnson’s, see John Terry, The Slave Who Was New (New York: W. W. Norton, 1985), 3-45.”)
8 ) CONCLUSION OF LITERATURE REVIEW:
Your conclusion should not only reiterate your argument (thesis), but also discuss questions that remain unanswered by the literature. What has the literature accomplished? What has not been studied? What debates need to be settled?
Additional writing guidelines
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- Costs, challenges and opportunities of decentralised chimeric antigen receptor T-cell production: a literature review and clinical experts’ interviews
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- http://orcid.org/0000-0001-9647-315X Gunar Stemer 1 , 2 ,
- Tarquin Mittermayr 3 ,
- Petra Schnell-Inderst 2 ,
- Claudia Wild 3
- 1 Pharmacy Department , University Hospital Vienna , Vienna , Austria
- 2 Institute of Public Health, Medical Decision Making and Health Technology Assessment , UMIT TIROL – University for Health Sciences and Technology , Hall in Tirol , Austria
- 3 Austrian Institute for Health Technology Assessment , Vienna , Austria
- Correspondence to Dr Gunar Stemer; gunar.stemer{at}akhwien.at
The objectives were to summarise the evidence and clinical experts’ views comparing the use of decentralised produced chimeric antigen receptor (CAR) T-cell therapies versus commercially available products, regarding drug costs, time to finalised product and other reported advantages, disadvantages, challenges and facilitators. A literature review according to the PRISMA guidelines was conducted in Medline, Embase and Trip databases. Publications were included if they reported information on cost estimates, time to finalised products and other outcomes of interest of a decentralised CAR T-cell production strategy. A structured interview guide was developed and used for qualitative expert interviews. Five experts were purposively selected, and interviews were either conducted face-to-face or online, and recorded for the purpose of transcription. Transcripts were analysed and categories and codes extracted. Reporting is based on the COREQ checklist for reporting qualitative research. Costs of decentralised produced CAR T-cells appear to be lower by a factor two to 14, compared with commercial products. But there is high uncertainty about this estimate, because it is unclear whether cost components included are comparable and due to the heterogeneity of the studies. The most commonly reported advantages were proximity to patients and decreased product risks and costs, whereas the continuing dependency on centrally manufactured reagents and specific characteristics of ‘fresh’ CAR T-cells are reported as disadvantages. Compliance with regulatory requirements is mentioned as the biggest challenge. The availability of closed-system production devices is reported as one main facilitator, as are clear commitment, secured financing and knowledge transfer from already experienced centres. Apparent cost differences open a field for healthcare decision-makers to discuss and justify investment costs for implementation of a complementing decentralised production programme and to realise other associated benefits of such a strategy, such as flexibility, patient proximity and expanding patient access.
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Data availability statement
Data sharing not applicable as no datasets generated and/or analysed for this study.
https://doi.org/10.1136/ejhpharm-2024-004130
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Analytical review of wind assessment tools for urban wind turbine applications.
1. Introduction
2. estimation of wind resources, 2.1. macroscale wind conditions, 2.2. microscale wind conditions, 3. wind assessment tools for the built environment.
- In situ measurements;
- Wind tunnel tests;
- Computational fluid dynamics simulations (CFD).
3.1. In Situ Measurements
3.2. wind tunnel tests.
- Geometric similarity where the ratios of linear dimensions are equal;
- Dynamic similarity where the ratios of forces are equal;
- Kinematic similarity where particle paths are geometrically similar.
- Accuracy in modelling the mean wind speed, turbulent kinetic energy, and turbulent dissipation rate vertically across the wind tunnel;
- Modelling the important properties of atmospheric turbulence, in particular the relevant length scale of the longitudinal turbulence component, with the same scale approximately the same scale as that used to model buildings or structures;
- Keeping the effect of the longitudinal pressure gradient across the wind tunnel minimal.
3.3. Computational Fluid Dynamics (CFD) Simulations
- CFD simulations are cost-effective when compared with other wind assessment tools, such as in situ measurements and wind tunnel tests. They are even becoming more economical with the increase in computational power.
- When comparing CFD simulations with other tools, CFD simulations can produce a wealth of quantitative and qualitative data across the study domain and not just point measurements.
- CFD simulations are not restricted by the similarity constraints previously discussed.
- CFD simulations are very effective in investigating design alternatives and studying alterations in designs to reach the optimum design solution. This advantage means that CFD speeds up the design process and the design decisions.
- CFD simulations are considered full-scale simulations, which is a big advantage when studying large urban areas or high-rise buildings. The alternative would be wind tunnel tests, which will be limited by the size of the wind tunnel.
- CFD simulations communicate the results easily in the form of meaningful visualisations, which could be understood by the majority of people.
- With low computational power, CFD simulations are not very accurate in simulating urban wind flow in high-density built environments. The turbulent nature of the urban wind flow in high-density built environment requires significant computational power.
- There is a high risk of inexperienced users using the tool without professional knowledge of fluid dynamics, which might result in the wrong interpretation of the produced data. The set of skills needed to confidently use CFD simulations is not common among planners, architects, and designers.
- Commercial CFD codes require a wide range of variables to be set up prior to the simulation, such as boundary conditions, turbulence model, grid type, discretisation schemes, adjustments in the ABL profile, etc. If any of these variables is wrong, it will significantly affect the simulation output. Thus, these variables should be specified carefully.
- Due to the complexity of the variables that need to be specified before the simulation, best practice guidelines should be followed as the first step to ensure reliable results, and then, validation against other wind assessment tools should be carried out. In some cases, the validation data are not available; in this case, the results should be treated carefully and interpreted with caution.
3.4. Relevance of Different Tools for Assessing Urban Wind Flow
4. potential of cfd simulations as an urban wind assessment tool, 4.1. cfd simulation of the urban wind flow, 4.2. cfd modelling parameters, 4.2.1. defining the physical model, 4.2.2. flow problem geometry, 4.2.3. dimensions of the computational domain, 4.2.4. computational domain boundary conditions.
- High mesh resolution in the vertical direction close to the bottom of the computational domain;
- Maintaining the horizontal homogeneity of the ABL profile upstream and downstream of the computational domain;
- The distance between the centre of the first cell away from the bottom boundary ( z p ) and the bottom wall boundary to be greater than the roughness height ( z p > k s );
- Roughness height equal to thirty times the roughness length ( z 0 ) ( k s = 30 z 0 ).
4.2.5. The Computational Mesh
5. conclusions, author contributions, institutional review board statement, informed consent statement, data availability statement, acknowledgments, conflicts of interest.
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Tools Arranged in Descending Order | |
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High accuracy | In Situ Measurements—Wind Tunnel—CFD |
High visualisation | CFD—Wind Tunnel—In Situ Measurements |
Preference of usage for existing developments | In Situ Measurements—CFD—Wind Tunnel |
Preference of usage for future developments | CFD—Wind Tunnel—In Situ Measurements |
Lowest cost | CFD—Wind Tunnel—In Situ Measurements |
Less time-consuming | CFD—Wind Tunnel—In Situ Measurements |
Availability to users | CFD—Wind Tunnel—In Situ Measurements |
Type of Terrain | z , Gradient Height (m) | α |
---|---|---|
Open terrain with very few obstacles such as open grass or farmland with few trees, hedgerows, and other barriers; prairie, tundra shores, low islands of inland, lakes, and deserts | 300 | 0.16 |
Terrain uniformly covered with obstacles 10 to 15 m in height; e.g., residential suburbs, small towns; woodland and shrub, small fields with bushes, trees, and hedges | 430 | 0.28 |
Terrain with large and irregular objects; e.g., centres of large cities, very broken country with many windbreaks of tall trees, etc. | 560 | 0.40 |
Category | z (m) | Remark |
---|---|---|
0 | 0.003 | Corresponding to large expanses of water, mudflats, snow-covered farmland, and large flat areas of tarmac |
1 | 0.01 | Corresponding to flat grassland, parkland, or bare soil, without hedges, and with very few isolated obstructions |
2 | 0.03 | Meteorological standard, basic terrain roughness corresponding to typical UK farmland, nearly flat or gently undulating countryside, fields with crops, fences or low boundary hedges and few trees |
3 | 0.1 | Corresponding to farmland with frequent boundary hedges, occasional small farm structures, houses, or trees |
4 | 0.3 | Corresponding to dense woodland, with domestic housing typically between 10% and 20% of plan-area density |
5 | 0.8 | Corresponding to city centres, comprising mostly four-storey buildings, or higher, typically between 30% and 50% plan-area density |
Second-order schemes or above are recommended for solving algebraic equations. | |
In the range of 10 to 10 . | |
Multiblock structured mesh. Carrying out a sensitivity analysis with three levels of refinements where the ratio of cells for two consecutive grids should be at least 3.4. Mesh cells to be equidistant while refining the mesh in areas of complex flow phenomena. If cells are stretched, a ratio not exceeding 1.3 between two consecutive cells should be maintained. | |
Realizable k-ε turbulence model. | |
Details of dimension equal to or more than 1 m to be included. | |
If H is the building height, the lateral dimension = 2H + building width. Flow direction dimension = 20H + building dimension in the flow direction. Vertical direction = 6H. A blockage ratio below 3% must be maintained. | |
Inflow: horizontally homogenous log law atmospheric boundary layer (ABL) velocity profile. Bottom: a no-slip wall with standard wall functions. Top and side: symmetry. Outflow: pressure outlet. |
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Abohela, I.; Sundararajan, R. Analytical Review of Wind Assessment Tools for Urban Wind Turbine Applications. Atmosphere 2024 , 15 , 1049. https://doi.org/10.3390/atmos15091049
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- Case report
- Open access
- Published: 29 August 2024
Liver and pancreas transplantation in adult donor and recipients with situs inversus totalis: a case series and review of the literature
- Alireza Shamsaeefar 1 ,
- Fatemeh Masjedi 2 ,
- Jamshid Roozbeh 2 ,
- Sahar Sohrabi Nazari 1 ,
- Edalat Zarei 1 ,
- Mehran Jafari 1 ,
- Sara Farifteh 1 ,
- Mohammad Alikhani 1 ,
- Mohammad Eslamian 1 ,
- Maryam Mardani 1 ,
- Reyhaneh Naseri 3 &
- Hamed Nikoupour 1
Journal of Medical Case Reports volume 18 , Article number: 398 ( 2024 ) Cite this article
Metrics details
Situs inversus totalis is a rare congenital anomaly characterized by a mirror-image orientation of abdominal, and in some cases, thoracic organs. Here, we report our situs inversus totalis transplantation experience and further review liver transplantations in adult recipients and donors with situs inversus totalis.
Case presentation
We describe three cases with situs inversus totalis. The first case was liver transplantation in a recipient (a 61-year-old Iranian man) with situs inversus totalis, the second was a liver transplantation from a donor (a 52-year-old Iranian woman) with situs inversus totalis, and finally, for the first time, a simultaneous pancreas and kidney transplantation in a recipient (a 26-year-old Iranian man) with situs inversus totalis. In patient one, hepatectomy could be performed according to the standard method and on the basis of preoperative studies. Hepatic vein and arterial anastomosis were performed as in every other patient without situs inversus totalis. To prevent biliary complications, a Roux-en-Y hepaticojejunostomy was performed. In patient two, implantation time, suprahepatic vein, portal vein, arterial, and biliary reconstruction could be done as in any other case without situs inversus totalis. Plication of the right-sided diaphragm and fixation of the falciform ligament was done for our patient. In patient three, systemic drainage was preferred to portal flow for establishing the outflow drainage of the pancreas compared with otherwise normal patients.
Although situs inversus totalis is a rare condition, our reported techniques are suitable, considering advantages such as easier accessibility, more acceptable placement of the implanted organs regarding vascular variations, and the appropriate location of the allograft in the proximity of other organs.
Peer Review reports
Introduction
Orthotopic liver transplantation (LTx) has become the standard and final treatment option for end-stage liver diseases. Because of the shortage of organs and the increasing number of patients who require transplantation, maximum effort is made to procure and transplant organs appropriately. Therefore, facing anatomical diversity and anomalies in the donor and recipient is inevitable [ 1 , 2 ]. One of these anomalies is situs inversus totalis (SIT). It is a rare congenital abnormality characterized by a mirror-image orientation of the abdominal, and in some cases, thoracic organs relative to the midline. The incidence of SIT is about 5–25 in every 100,000 births [ 3 ]. Implanting a mirror-image organ may pose a technical challenge to a transplant surgeon because of the reversed position and orientation of the graft and vascular system. Some of the potential risks include vascular torsion and hepatic venous outflow kinking, inferior vena cava (IVC) compression, need for additional vascular reconstruction, and pressure effect on the stomach due to the placement of the greater right lobe in the recipient’s hepatic fossa [ 4 ].
In addition, SIT is often associated with other anomalies such as biliary atresia (BA), polysplenia syndrome (interrupted IVC with azygous drainage, confluent hepatic veins to the right atrium, preduodenal portal vein, hypoplastic or atretic portal vein, and aberrant hepatic arterial anatomy), congenital heart disease, Kartagener’s syndrome, and midgut malrotation that would eventually make the transplantation more complex [ 3 , 5 , 6 ].
The most documented association of SIT is with BA, which is a cause of end-stage liver disease among pediatrics. Approximately 28% of children with SIT have BA [ 7 ]. Accordingly, most cases of transplantation in SIT are reported in this group.
Although most people with SIT have a normal life without complications, this condition could be problematic when they require surgery, especially LTx [ 8 ]. Due to these difficulties, SIT was previously considered a contraindication for LTx. Advances in surgical technique and experience have overcome these limitations [ 9 , 10 ].
However, experiences with SIT are still limited, and different techniques have been used according to each individual’s circumstances. Here, we first describe a case of LTx in a SIT recipient, then a successful LTx from a donor with SIT, and finally, for the first time, we report on a pancreas transplantation in a SIT recipient.
We collected medical records of patients diagnosed with SIT who underwent transplant surgery from January 2018 to September 2023, affiliated with Shiraz Organ Transplant Center, Abu-Ali-Sina Hospital, Shiraz University of Medical Sciences. The Shiraz University of Medical Sciences Ethics Committee approved this study (IR.SUMS.REC.1402.570). Three written informed consents were obtained from patients for the publication of these case reports and any accompanying images.
A 61-year-old Iranian man with a known case of alcoholic liver cirrhosis with complete situs inversus was referred to our center with severe ascites and grade II encephalopathy. He had stopped drinking alcohol a year before. During the previous 6 months, he suffered from severe ascites and required multiple peritoneal paracentesis, resulting in three emergency department admissions. Because of the increase in creatinine level (up to 2 mg/dL) and an existing hepatorenal syndrome, the patient was on the waiting list for LTx. Computed tomography showed that the arterial blood supply to the liver originated from the celiac axis with no evidence of the replaced hepatic artery. He had no associated vascular and visceral anomalies (Fig. 1 ). In other words, there were no signs of intestinal malrotation or intermittent IVC. The model for end-stage liver disease (MELD) score was 24 at admission, and his height and body weight were 178 cm and 95 kg, respectively.
Pre-transplant contrast-enhanced abdominal computed tomography findings showing a complete situs inversus with a mirror-image positioning of abdominal organs
In April 2022, he had LTx and received an ABO-compatible whole liver from a 75 kg, 44-year-old donor whose graft weighed 1.4 kg. Dissection of the hepatic hilum was performed without unexpected difficulty, but hepatectomy was done with standard technique (resection of recipient’s IVC with liver). The liver was directly placed into the recipient’s left upper quadrant without rotating adjustment; the right hepatic lobe was positioned on the recipient’s left side, and the left liver lobe was placed in the recipient’s previous liver fossa. The hepatic superior and inferior vena cava were directly anastomosed to the recipient’s IVC with 3–0 vascular sutures. Portal veins were anastomosed end-to-end with 6–0 polypropylene sutures. The cold ischemia time was 4 hours.
Arterial reconstruction was done using an end-to-end technique with a 7–0 continuous suture. Biliary reconstruction was performed by duct-to-duct anastomosis between the recipient’s common bile duct and the donor’s common hepatic duct with polydioxanone sutures (PDS); however, seemingly, there was some tension on the anastomosis site. Finally, to prevent the rotation of the transplanted liver, diaphragm plication and fixation of the falciform ligament to the diaphragm were carried out. The total operation time was 6.5 hours, and the patient was extubated 12 hours after the operation; no veno-venous bypass was used during the anhepatic phase. On postoperative day 12, the patient’s serum bilirubin levels increased to 5 mg/dL, and biliary fluid passed through the incision site, so exploration was done for the patient. Exploration showed that the anterior side of the previous common bile duct anastomosis was disrupted. Accordingly, we took the last biliary anastomosis and reconstituted it by a Roux-en-Y hepaticojejunostomy. The patient was discharged from the hospital on day 25 post-transplantation.
Considering the anatomical differences between the recipient with situs inversus and the recipient with normal anatomy, the transplantation technique seems modified to prevent complications following LTx. As shown in Fig. 2 A, the direction of the recipient’s bile duct and portal vein had an acute angle to the donor’s liver. Due to this anatomical difference, performing Roux-en y hepaticojejunostomy would potentially result in fewer complications than duct-to-duct anastomosis. Furthermore, for portal vein anastomosis, the length of the portal vein should be as short as possible to prevent kinking and future portal vein thrombosis. Given that the left lobe of the donor’s liver is located in the space that was previously the location of the right lobe of the recipient’s liver, this mismatch can cause a possible rotation of the transplanted liver. To prevent this complication, ipsilateral diaphragm plication and fixation of the falciform ligament to the diaphragm were carried out (Fig. 2 B).
Completion of the suprahepatic, portal, and arterial reconstructions in the recipient with situs inversus totalis following orthotopic liver transplantation (patient 1) ( A ) and schematic orientation of the liver transplant inside the recipient’s body with situs inversus totalis ( B )
A 52-year-old Iranian woman was admitted due to intracerebral brain hemorrhage (ICH) and was diagnosed with brain death 2 days after admission. The patient was prepared for organ donation. Dextrocardia was discovered in chest radiography, and SIT was confirmed after abdominal ultrasonography. During the procurement procedure, we found the liver, pancreas, spleen, and stomach on the opposite side; the aorta was on the right side, and IVC was on the left side and anterior to the spine (Fig. 3 A). There was no problem during the procedure; however, the operation time was longer than usual due to meticulous dissection. During bench surgery, the common bile duct was on the left side of the hilum, and the proper hepatic artery was on the right side. Still, no anatomical variation was seen in the hepatic artery, and portal vein was in the posterior position. Arterial structures were preserved with an aorta patch, and IVC was excised to the longest length possible. The donor’s liver weighed 1.2 kg.
Liver anatomy in deceased donor with situs inversus totalis (patient 2) ( A ) and schematic orientation of the liver transplant inside the recipient’s body with normal anatomy ( B )
The recipient was a 48-year-old man with a history of decompensated cirrhosis due to non-alcoholic steatohepatitis (NASH) and was a candidate for LTx. Hepatectomy was performed with the piggyback method, and the implantation was done with the liver placement in the middle part of the upper abdomen. The right lobe of the liver graft was placed toward the recipient’s left side. Outflow was established by anastomosis of the donor’s suprahepatic vena cava to the recipient’s common funnel of hepatic veins. The distal end of the donor cava was ligated. The portal vein was anastomosed using the end-to-end technique. The liver perfusion was established without any problems. Arterial reconstruction was done using the end-to-end technique by anastomosis of the donor’s hepatic artery to the recipient’s common hepatic artery. Finally, duct-to-duct anastomosis was done without tension. To prevent the rotation of the liver and to eliminate the empty space on the right side, we plicated the right diaphragm and the falciform ligament (Fig. 3 B). The patient was discharged without any complications.
A 26-year-old Iranian man with diabetic nephropathy was referred to our clinic for pancreas transplantation. He was on continuous insulin therapy without proper glycemic control from 10 years ago. He had also lost his vision due to diabetic retinopathy. During previous imaging studies, SIT was identified, and associated vascular anomalies were documented.
The donor was a 36-year-old man who developed brain death due to subdural hematoma following a traumatic brain injury. Grafts were in good condition with normal function.
During bench surgery, we made a combined patch of the celiac trunk and superior mesenteric artery (SMA) from the donor’s aorta to avoid separate anastomosis or using a Y-graft. The donor’s portal vein behind the pancreas was also prepared for venous outflow.
Laparotomy was done through a midline incision. The aorta and left-sided IVC were localized. Considering the SIT, the surgeon was on the right side of the patient. The prepared portal vein was anastomosed to the IVC as an outflow pathway, and the Carel patch was anastomosed to the recipient’s common iliac artery. The donor’s duodenum was anastomosed to the nearest loop of the jejunum from the recipient (Fig. 4 ).
Pancreas anatomy following transplantation in recipient with situs inversus totalis (patient 3)
No unexpected event occurred following declamping, and normal blood sugar levels were achieved quickly. The kidney was transplanted on the right side to achieve better access to the iliac vessels. The hospital course was uneventful except for an episode of rejection diagnosed with elevated creatinine levels. The patient received one course of methylprednisolone and recovered completely.
In cases of SIT, organ transplantation may be complicated. Both donors and recipients can have SIT, although matched donor-recipient combinations are unlikely to be found due to their rarity. However, there are several reports on children and adults with SIT undergoing LTx. Literature on LTx in SIT is presented in Table 1 .
Despite SIT being a rare developmental defect during embryogenesis, it is not considered a contraindication for organ transplantation, whether as a donor or recipient. Further, we should keep in mind that the risk of surgical complications may increase because of anatomical variation in the positioning of the vasculature.
The liver is an asymmetric organ that is always affected by SIT-related anatomic abnormalities. As a result, donation from a donor with SIT and transplantation for a recipient with SIT are complicated surgical procedures. Because of the technical challenges associated with the unusual vascular architecture and concerns related to proper graft location, SIT was formerly considered a contraindication for LTx [ 11 ]. The two main problems for orthotopic LTx in SIT seem to be (i) having to place the graft’s greater right lobe over the right-sided stomach and (ii) the presence of a large empty space in the left upper quadrant, which predisposes the graft to lateral displacement and kinking of the hepatic veins [ 12 ].
Even though several successful strategies have been suggested, there has yet to be agreement on a standard technique. These techniques include (i) plication of the left diaphragm combined with graft fixation with a percutaneously inserted gastric balloon of the Sengstaken–Blakemore tube [ 13 ]; (ii) transplantation of a portion of the liver from a living donor (that is, reduced size) [ 8 ]; (iii) different degrees (15–90°) of lateral rotation of the graft (clockwise in SIT recipients and counter-clockwise in SIT donors) using standard piggyback, end-to-side, or side-to-side cavo-caval anastomosis [ 2 , 8 , 14 , 15 , 16 , 17 ]; and (iv) 180° flip of the graft (retroversus or backward facing) [ 18 , 19 , 20 , 21 ] (see Table 1 ). Regarding living donations, segmental LTx allows the transplant surgeon greater flexibility in determining the best choice. New technologies, such as three-dimensional (3D) printing, can aid surgery planning if there is enough time for preoperative planning [ 22 ].
In our case (patient 1), performing Roux-en-Y hepaticojejunostomy potentially has fewer complications compared with duct-to-duct anastomosis. In addition, for portal vein anastomosis, the length of the portal vein should be as short as possible to prevent kinking and future portal vein thrombosis. To prevent the rotation of the transplanted liver, ipsilateral diaphragm plication and fixation of the falciform ligament to the diaphragm were used.
Moreover, there were few reports on using a liver from a donor with SIT. The most challenging part of these cases is the venous outflow reconstruction. In 1995, Asfar and Ozcay [ 23 ] reported transplantation with a liver from a SIT donor. They rotated the liver 90° counter-clockwise and performed an end-to-side anastomosis between the donor’s intrahepatic vena cava and the recipient’s IVC.
In other reports, authors mentioned different methods, such as backward rotation of the liver 180° along the axis of the IVC or T-shape anastomosis between the left and middle hepatic veins and IVC. In our case (patient 2), we performed the piggyback technique for hepatectomy, IVC was preserved, and the liver was implanted with its original orientation. Anastomosis between the donor’s suprahepatic vena cava and the recipient’s common funnel of hepatic veins was performed, and there was no need for significant rotation of the liver. Another issue that should be considered is the empty space on the right side of the upper abdomen. In our case, we plicated the diaphragm, but in some case reports, the omentum has been used. Fixation of the falciform is also helpful. A smaller graft might be more logical for preventing compression on the IVC or stomach.
To the authors’ knowledge, no previous reports existed for pancreas transplantation in SIT. For this, a systemic approach must be selected due to technical difficulties that may be encountered using conventional portal-portal anastomosis. In SIT cases, the aorta is localized far from the portal system, so using iliac vessels and the superior mesenteric vein (SMV) leads to inappropriate angulation and puts the graft at risk of vascular compromise. In addition, in the method used for this case (patient 3), the graft is positioned perpendicularly, taking a better position in the abdomen with reversely placed organs. Our center's policy is to place the left kidney in the left retroperitoneum for simultaneous kidney and pancreas transplantations. In this case, we used the left kidney on the right side as it provided us with better exposure and vascular anatomy for implantation. Although we encountered complexities, our technique presented a suitable option for this anomaly due to advantages such as easier accessibility, better placement of the implanted organs regarding vascular variations, and the appropriate location of the allograft in the proximity of other organs.
On the basis of previous literature and our experience, we advocate applying specific techniques, which are as follows: our recommendations in organ recipients with SIT: (1) ergonomy; the transplant surgeon should be on the left side of the patient during the operation; hepatectomy can be done as a standard or piggyback method; however, we recommend using the standard technique if the patient has a good cardiopulmonary reserve that can tolerate total clamping of the IVC; (2) implantation; hepatic vein and arterial anastomosis can be performed as with normal patients, the portal vein should be shortened as much as possible, and to prevent biliary complications, we suggest Roux-en-Y hepaticojejunostomy and organ rotation are not mandatory in all cases; and (3) plication of the diaphragm and fixation of the liver are recommended in the recipient.
Our recommendations in deceased donors with SIT anatomy are as follows: (1) hepatectomy can be carried out using a standard or piggyback method based on preoperation studies; (2) suprahepatic vein, portal vein, and arterial and biliary reconstruction can be done similarly to normal patients, and implantation time can be similar; whether a liver rotation is performed depends on the surgeon’s preference; and (3) plication of the right-sided diaphragm and fixation of the falciform ligament are advised in all patients.
Our recommendations in simultaneous pancreas and kidney transplantation with SIT anomaly are as follows: (1) standing on the left side of the patient results in more comfortable access during operation; (2) for establishing outflow drainage, systemic drainage is preferred to portal drainage; (3) for anastomosis of arterial graft, if the procurement team of the liver and pancreas is the same, the patch of the celiac trunk and SMA is to be given to the pancreas, and this patch is directly anastomosed to the aorta; and (4) kidney is placed in the right side in the retroperitoneal space, and anastomosis can be done as usual.
Finally, more acceptable outcomes can be achieved with meticulous perioperative planning, a complete anatomic understanding of the liver and pancreas in the donor and recipient, and the use of novel procedures.
Availability of data and materials
The datasets used and/or analyzed during the current study are available from the corresponding author upon reasonable request.
Abbreviations
Biliary atresia
Inferior vena cava
Liver transplantation
Model for end-stage liver disease
Non-alcoholic steatohepatitis
- Situs inversus totalis
Superior mesenteric vein
Simultaneous pancreas kidney transplantation
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Acknowledgements
The authors wish to thank Ms. Sheryl Thomas-Nikpoor, Language Editor at Springer Publications, for her invaluable comments in editing this manuscript.
The study was funded by the Vice Chancellor of Research Affairs, Shiraz University of Medical Sciences (ID: 29887), Shiraz, Iran.
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Shiraz Organ Transplant Center, Abu-Ali-Sina Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
Alireza Shamsaeefar, Sahar Sohrabi Nazari, Edalat Zarei, Mehran Jafari, Sara Farifteh, Mohammad Alikhani, Mohammad Eslamian, Maryam Mardani & Hamed Nikoupour
Shiraz Nephro-Urology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
Fatemeh Masjedi & Jamshid Roozbeh
Thoracic and Vascular Surgery Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
Reyhaneh Naseri
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Contributions
FM, SSN, EZ, MJ, SF, ME, and MM wrote the main manuscript text, and MA prepared Figs. 2 , 3 , 4 . All authors reviewed the manuscript. AS, JR, and HN contributed to the conception and design of the study. FM and RN contributed to the interpretation of data. All authors contributed to the article and approved the submitted version.
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Correspondence to Hamed Nikoupour .
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All procedures performed in studies involving human participants were in accordance with the ethical standards of the local Medical Ethics Committee of Shiraz University of Medical Sciences (IR.SUMS.REC.1402.570) and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.
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Shamsaeefar, A., Masjedi, F., Roozbeh, J. et al. Liver and pancreas transplantation in adult donor and recipients with situs inversus totalis: a case series and review of the literature. J Med Case Reports 18 , 398 (2024). https://doi.org/10.1186/s13256-024-04720-y
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Received : 26 December 2023
Accepted : 12 July 2024
Published : 29 August 2024
DOI : https://doi.org/10.1186/s13256-024-04720-y
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Background Situs inversus totalis is a rare congenital anomaly characterized by a mirror-image orientation of abdominal, and in some cases, thoracic organs. Here, we report our situs inversus totalis transplantation experience and further review liver transplantations in adult recipients and donors with situs inversus totalis. Case presentation We describe three cases with situs inversus ...