Cytomegalovirus infection contributes to acute rejection in solid organ transplant recipients: a systematic review and meta-analysis.

IF 3 3区医学 Q2 INFECTIOUS DISEASES

BMC Infectious Diseases Pub Date : 2025-09-29 DOI:10.1186/s12879-025-11648-1

Amirreza Keyvanfar, Shabnam Tehrani, Mahdi Falah Tafti, Niki Talebian, Zahra Mohammadi, Mahsa Hojabri, Sepehr Ramezani, Mehrdad Yasaei, Setareh Khorrami, Shiva Nezami, Negar Ghaedi, Davood Yadegarynia, Elahe Eghbal, Hanieh Najafiarab

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引用次数: 0

Abstract

Background: Solid organ transplant (SOT) recipients receive immunosuppressive drugs that predispose them to opportunistic infections, including cytomegalovirus (CMV) infection. In these patients, CMV infection can lead to life-threatening consequences, such as transplant rejection. This systematic review and meta-analysis investigated the role of CMV infection in the development of acute rejection in SOT recipients.

Methods: PubMed, Embase, Scopus, and Web of Science databases were systematically searched for eligible publications until Jan 31, 2025. English-language studies reporting the association between CMV infection and acute rejection in adult SOT recipients were included. Baseline characteristics, transplanted organs, and CMV infection and acute rejection status in SOT recipients were independently extracted by two reviewers. The pooled odds ratio (ORs) with a 95% confidence interval (CI) was calculated using the random effect model.

Results: Overall, 27 studies with 6308 SOT recipients entered the meta-analysis. Acute rejection was significantly higher in SOT recipients with CMV infection than those without CMV infection (OR = 2.02, 95%CI 1.64-2.49, I² = 40.44%). Acute rejection was significantly higher in recipients of liver (OR = 4.43, 95%CI 2.20-8.92, I² = 0.00%), kidney (OR = 2.22, 95%CI 1.70-2.89, I² = 48.72%), and lung (OR = 1.38, 95%CI 1.01-1.90, I² = 0.00%), if they were infected with CMV. While acute rejection was not significantly associated with CMV infection in heart transplant recipients (OR = 1.49, 95%CI 0.54-4.12, I² = 18.83%). Furthermore, Egger's test did not indicate any evidence of publication bias (P = 0.7440).

Conclusions: CMV infection approximately doubles the risk of acute rejection in SOT recipients. This association differs between various organs, with liver transplants indicating the highest risk, followed by kidney and lung transplants.

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巨细胞病毒感染导致实体器官移植受者急性排斥反应：系统回顾和荟萃分析。

背景：实体器官移植（SOT）受者接受免疫抑制药物治疗，易发生机会性感染，包括巨细胞病毒（CMV）感染。在这些患者中，巨细胞病毒感染可导致危及生命的后果，如移植排斥反应。本系统综述和荟萃分析调查了巨细胞病毒感染在急性排斥反应发生中的作用。方法：系统检索PubMed、Embase、Scopus和Web of Science数据库，检索2025年1月31日之前符合条件的出版物。包括报道成人SOT受者巨细胞病毒感染与急性排斥反应之间关系的英语研究。两名评论者独立提取了SOT受者的基线特征、移植器官、巨细胞病毒感染和急性排斥状态。采用随机效应模型计算95%置信区间（CI）的合并优势比（ORs）。结果：总共有27项研究纳入了6308名SOT接受者。感染巨细胞病毒的急性排斥反应明显高于未感染巨细胞病毒的急性排斥反应（OR = 2.02, 95%CI 1.64-2.49, I2 = 40.44%）。急性排斥反应在肝脏（OR = 4.43, 95%CI 2.20-8.92, I2 = 0.00%）、肾脏（OR = 2.22, 95%CI 1.70-2.89, I2 = 48.72%）和肺部（OR = 1.38, 95%CI 1.01-1.90, I2 = 0.00%）感染巨细胞病毒的受体中明显更高。而心脏移植受者的急性排斥反应与巨细胞病毒感染无显著相关性（OR = 1.49, 95%CI 0.54-4.12, I2 = 18.83%）。此外，Egger检验未发现任何发表偏倚的证据（P = 0.7440）。结论：巨细胞病毒感染使SOT受者发生急性排斥反应的风险增加约一倍。这种关联在不同器官之间有所不同，肝移植的风险最高，其次是肾和肺移植。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

BMC Infectious Diseases 医学-传染病学

CiteScore

6.50

自引率

0.00%

发文量

860

审稿时长

3.3 months

期刊介绍： BMC Infectious Diseases is an open access, peer-reviewed journal that considers articles on all aspects of the prevention, diagnosis and management of infectious and sexually transmitted diseases in humans, as well as related molecular genetics, pathophysiology, and epidemiology.