Do allografts present a risk to burn patients? Allografts and HLA-sensitization

IF 3.2 3区医学 Q2 CRITICAL CARE MEDICINE

Burns Pub Date : 2025-02-14 DOI:10.1016/j.burns.2025.107424

Joshua Tsai , Luka Kim , Isabel Jones , Samuel Culbert , Tuna Ozyurekoglu

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引用次数: 0

Abstract

Objective

This meta-analysis aimed to quantify sensitization rates following allograft usage and determine whether allografts have an increased risk of long-term sensitization compared to alternative therapies in burn patients.

Methods

Systematic review, meta-analysis and meta-regression of post-operative sensitization in burn patients were performed following Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidance (Prospero registration: CRD42024497137). Database searches were conducted on MEDLINE, Embase, CENTRAL using ProQuest Dialog.

We included all studies reporting post-operative sensitization in burn patients that were not case series or singular case reports. Meta-analysis was used to compare the risk of sensitization for allograft versus alternative therapies.

Results

Six studies (Allograft Patients: 71; Non-Allograft Patients: 95) were included (n = 166). Overall, 73 % (CI: 39 %-92 %) of burn patients were sensitized following allograft. Patients receiving allograft were at a significantly increased risk of sensitization (OR 13.14 [95 % CI: 1.32–131.00]). However, on sub-group analysis, when directly comparing patients who received allograft and transfusion versus those who received transfusion alone, there was not a significantly increased risk of sensitization (OR 7.68 [95 % CI:.61–95.86]).

Conclusion

Allograft is associated with a significantly increased risk of sensitization in burn patients. However, it is not clear whether burn patients already receiving transfusion will have an increased risk of sensitization from adding allograft. Further studies are required to demonstrate the multifactorial causes of sensitization within the burned population to explain the significance of the contribution from allograft and/or transfusion reported within the literature. Clinicians must carefully weigh the immediate benefits of allografts against the potential long-term challenges of sensitization, especially where alternative wound therapies are possible.

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来源期刊

Burns 医学-皮肤病学

CiteScore

4.50

自引率

18.50%

发文量

304

审稿时长

72 days

期刊介绍： Burns aims to foster the exchange of information among all engaged in preventing and treating the effects of burns. The journal focuses on clinical, scientific and social aspects of these injuries and covers the prevention of the injury, the epidemiology of such injuries and all aspects of treatment including development of new techniques and technologies and verification of existing ones. Regular features include clinical and scientific papers, state of the art reviews and descriptions of burn-care in practice. Topics covered by Burns include: the effects of smoke on man and animals, their tissues and cells; the responses to and treatment of patients and animals with chemical injuries to the skin; the biological and clinical effects of cold injuries; surgical techniques which are, or may be relevant to the treatment of burned patients during the acute or reconstructive phase following injury; well controlled laboratory studies of the effectiveness of anti-microbial agents on infection and new materials on scarring and healing; inflammatory responses to injury, effectiveness of related agents and other compounds used to modify the physiological and cellular responses to the injury; experimental studies of burns and the outcome of burn wound healing; regenerative medicine concerning the skin.