Progress in Transplantation最新文献

{"title":"Organ Transplantation Outcomes of Deceased Organ Donors in Organ Procurement Organization-Based Recovery Facilities Versus Acute-Care Hospitals.","authors":"Emily A Vail, Douglas E Schaubel, Peter L Abt, Niels D Martin, Peter P Reese, Mark D Neuman","doi":"10.1177/15269248231164176","DOIUrl":"10.1177/15269248231164176","url":null,"abstract":"<p><strong>Introduction: </strong>Recovery of donated organs at organ procurement organization (OPO)-based recovery facilities has been proposed to improve organ donation outcomes, but few data exist to characterize differences between facilities and acute-care hospitals.</p><p><strong>Research question: </strong>To compare donation outcomes between organ donors that underwent recovery procedures in OPO-based recovery facilities and hospitals.</p><p><strong>Design: </strong>Retrospective study of Organ Procurement and Transplantation Network data. From a population-based sample of deceased donors after brain death April 2017 to June 2021, donation outcomes were examined in 10 OPO regions with organ recovery facilities. Primary exposure was organ recovery procedure in an OPO-based organ recovery. Primary outcome was the number of organs transplanted per donor. Multivariable regression models were used to adjust for donor characteristics and managing OPO.</p><p><strong>Results: </strong>Among 5010 cohort donors, 2590 (51.7%) underwent recovery procedures in an OPO-based facility. Donors in facilities differed from those in hospitals, including recovery year, mechanisms of death, and some comorbid diseases. Donors in OPO-based facilities had higher total numbers of organs transplanted per donor (mean 3.5 [SD1.8] vs 3.3 [SD1.8]; adjusted mean difference 0.27, 95% confidence interval 0.18-0.36). Organ recovery at an OPO-based facility was also associated with more lungs, livers, and pancreases transplanted.</p><p><strong>Conclusion: </strong>Organ recovery procedures at OPO-based facilities were associated with more organs transplanted per donor than in hospitals. Increasing access to OPO-based organ recovery facilities may improve rates of organ transplantation from deceased organ donors, although further data are needed on other important donor management quality metrics.</p>","PeriodicalId":20671,"journal":{"name":"Progress in Transplantation","volume":"33 2","pages":"110-120"},"PeriodicalIF":0.6,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/7b/cb/10.1177_15269248231164176.PMC10150267.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9507453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of Eculizumab Use in Renal Transplant Recipients.","authors":"Kathryn Norville,&nbsp;Jenise Stephen,&nbsp;Carolyn Mead-Harvey,&nbsp;Rebecca Corey,&nbsp;Cassandra Votruba","doi":"10.1177/15269248231164163","DOIUrl":"https://doi.org/10.1177/15269248231164163","url":null,"abstract":"<p><p><b>Introduction:</b> Eculizumab is a monoclonal antibody that binds to complement protein C5, inhibiting complement-mediated thrombotic microangiopathy. It is approved for several indications including atypical hemolytic uremic syndrome. Additionally, eculizumab is used off-label for antibody-mediated rejection and C3 glomerulopathy in renal transplant recipients. Due to limited data available, the purpose of this study was to describe the use of eculizumab treatment in renal transplant recipients. <b>Design:</b> This retrospective single-center study evaluated the safety and efficacy of eculizumab for on- and off-label indications in renal transplant recipients. Adult renal transplant recipients receiving at least 1 dose of eculizumab posttransplant between October 2018 and September 2021 were included. The primary outcome evaluated was graft failure in patients treated with eculizumab. <b>Results:</b> Forty-seven patients were included in analysis. The median age at eculizumab initiation was 51 years [IQR 38-60], with 55% being female. Indications for eculizumab included atypical hemolytic uremic syndrome/thrombotic microangiopathy (63.8%), antibody-mediated rejection (27.7%), C3 glomerulopathy (4.3%), and other (4.3%). Graft failure occurred in 10 patients (21.3%) with a median of 2.4 weeks [IQR 0.5-23.3] from transplant to graft failure. At last follow-up (median 56.1 weeks), 44 (93.6%) patients were alive. After eculizumab initiation, renal function improved at 1 week, 1 month, and last follow-up. <b>Conclusion:</b> Eculizumab treatment demonstrated a benefit on graft and patient survival compared to reported incidence in thrombotic microangiopathy and antibody-mediated rejection. Due to the small sample size and retrospective design, further research is warranted to confirm these results.</p>","PeriodicalId":20671,"journal":{"name":"Progress in Transplantation","volume":"33 2","pages":"162-167"},"PeriodicalIF":0.8,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9862802","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Goal-Directed Haemodynamic Therapy Improves Patient Outcomes in Kidney Transplantation.","authors":"Jez Fabes,&nbsp;Ammar Al Midani,&nbsp;Aman S Sarna,&nbsp;Dina H Hadi,&nbsp;Saqib A Naji,&nbsp;Neal R Banga,&nbsp;Gareth L Jones,&nbsp;Peter D Berry,&nbsp;Marc D Wittenberg","doi":"10.1177/15269248231164165","DOIUrl":"https://doi.org/10.1177/15269248231164165","url":null,"abstract":"<p><p><b>Introduction:</b> Kidney transplant graft function depends on optimised haemodynamics. However, high fluid volumes risk hypervolaemic complications. The Edwards Lifesciences ClearSight™ device permits fluid titration through markers of preload and beat-to-beat blood pressure monitoring. We evaluated the implementation of a novel goal-directed haemodynamic therapy protocol to determine whether patient outcomes had improved. <b>Design:</b> A retrospective evaluation of standard care versus goal-directed haemodynamic therapy in adults undergoing kidney transplantation was performed in a single centre between April 2016 and October 2019. Twenty-eight standard-of-care patients received intraoperative fixed-rate infusion and 28 patients received goal-directed haemodynamic therapy. The primary outcome was volume of fluid administered intraoperatively. Secondary outcomes included blood product and vasoactive drug exposure, graft and recipient outcomes. <b>Results:</b> Intraoperative fluid administered was significantly reduced in the goal-directed haemodynamic therapy cohort (4325 vs 2751 ml, <i>P</i> < .001). Exposure to vasopressor (67.9% vs 42.9%, <i>P</i> = .060) and blood products (17.9% vs 3.6%, <i>P</i> = .101) was unchanged. Immediate graft function (82.1% vs 75.0%, <i>P</i> = .515), dialysis requirement (14.3% vs 21.4%, <i>P</i> = .729) and creatinine changes post-operatively were unchanged. In the goal-directed haemodynamic therapy cohort, 1 patient had pulmonary oedema (3.6%) versus 21.4% in the standard cohort. Patients in the goal-directed haemodynamic therapy group were more likely to mobilise within 48 hours of surgery (number needed to treat = 3.5, <i>P</i> = .012). <b>Conclusions:</b> Protocolised goal-directed haemodynamic therapy in kidney transplantation was safe and may improve patient, graft, and surgical outcomes. Clinical trials assessing goal-directed approaches are needed.</p>","PeriodicalId":20671,"journal":{"name":"Progress in Transplantation","volume":"33 2","pages":"150-155"},"PeriodicalIF":0.8,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9501134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"External Validation of the United Kingdom Transplant Benefit Score in Australia and New Zealand.","authors":"Eunice G Lee,&nbsp;Marcos V Perini,&nbsp;Enes Makalic,&nbsp;Gabriel C Oniscu,&nbsp;Michael A Fink","doi":"10.1177/15269248221145047","DOIUrl":"https://doi.org/10.1177/15269248221145047","url":null,"abstract":"<p><p><b>Introduction:</b> In Australia and New Zealand, liver allocation is needs based (based on model for end-stage liver disease score). An alternative allocation system is a transplant benefit-based model. Transplant benefit is quantified by complex waitlist and transplant survival prediction models. <b>Research Questions:</b> To validate the UK transplant benefit score in an Australia and New Zealand population. <b>Design:</b> This study analyzed data on listings and transplants for chronic liver disease between 2009 and 2018, using the Australia and New Zealand Liver and Intestinal Transplant Registry. Excluded were variant syndromes, hepatocellular cancer, urgent listings, pediatric, living donor, and multi-organ listings and transplants. UK transplant benefit waitlist and transplant benefit score were calculated for listings and transplants, respectively. Outcomes were time to waitlist death and time to transplant failure. Calibration and discrimination were assessed with Kaplan-Meier analysis and C-statistics. <b>Results:</b> There were differences in the UK and Australia and New Zealand listing, transplant, and donor populations including older recipient age, higher recipient and donor body mass index, and higher incidence of hepatitis C in the Australia and New Zealand population. Waitlist scores were calculated for 2241 patients and transplant scores were calculated for 1755 patients. The waitlist model C-statistic at 5 years was 0.70 and the transplant model C-statistic was 0.56, with poor calibration of both models. <b>Conclusion:</b> The UK transplant benefit score model performed poorly, suggesting that UK benefit-based allocation would not improve overall outcomes in Australia and New Zealand. Generalizability of survival prediction models was limited by differences in transplant populations and practices.</p>","PeriodicalId":20671,"journal":{"name":"Progress in Transplantation","volume":"33 1","pages":"25-33"},"PeriodicalIF":0.8,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9085984","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Short Tutorial for Constructing Meaningful Tables Using AMA Style.","authors":"Rebecca P Winsett","doi":"10.1177/15269248231152923","DOIUrl":"https://doi.org/10.1177/15269248231152923","url":null,"abstract":"Constructing meaningful tables is important for any journal publication. This short tutorial is specific to the journal Progress in Transplantation that uses the AMA Manual of Style; however, the information may be useful for any presentation, internal report, or journal publication. The information is not meant to be comprehensive but to give pointers for authors to consider when developing tables to include in a manuscript. How often have we seen large comprehensive data crushed into a single table? The question from an editor or reader becomes: Is all the information pertinent to the manuscript submitted? Burying the important information within a large multirow, multi-column table often detracts from the major findings of the study. The tendency to overwhelm the reader with an excessive amount of data that does not pertain to the study’s purpose is tempting. It is often easier to include all data collected than to decide what variables are key to show that the study’s questions were answered. Tables are planned to match the manuscript.","PeriodicalId":20671,"journal":{"name":"Progress in Transplantation","volume":"33 1","pages":"3-4"},"PeriodicalIF":0.8,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10784584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk Factors for First and Recurrent Fractures among Kidney Transplant Recipients.","authors":"Norman Atagu,&nbsp;Stefani Mihilli,&nbsp;Huong Thao Nguyen,&nbsp;Alicia Wu,&nbsp;Olusegun Famure,&nbsp;Yanhong Li,&nbsp;S Joseph Kim","doi":"10.1177/15269248221145034","DOIUrl":"https://doi.org/10.1177/15269248221145034","url":null,"abstract":"<p><p><b>Introduction:</b> Kidney transplantation is associated with increased risk of bone fracture. Current literature reports widely variable fracture burden and contains limited data on risk factors for recurrent fractures. <b>Methods:</b> The incidence of all and major osteoporotic fractures (hip, forearm, thoracolumbar, and proximal humerus) were assessed. The risk factors for first and recurrent fractures among 1285 Canadian kidney transplant recipients transplanted between January 1, 2004, and December 31, 2013 were also identified. <b>Results:</b> The 10-year cumulative incidence of all fractures and major osteoporotic fractures in this population was 27.1% (95% CI: 22.5, 32.4) and 17.8% (95% CI: 13.4, 23.5), respectively. On multivariable analysis, female sex (HR = 1.64 [95% CI: 1.20, 2.26]), history of fracture (HR = 1.54 [95% CI: 1.12, 2.11]), and pretransplant diabetes (HR = 1.85 [95% CI: 1.29, 2.65]) were recipient factors found to increase the risk for any first fracture posttransplant. These risk factors persist in analysis with the time origin 3-months posttransplant, where transplant age (HR = 1.01 [95% CI: 1.00, 1.03]) and increased time on pretransplant dialysis (HR = 1.06 [95% CI: 1.00, 1.12]) also emerge as risk factors for first fracture. On multivariable shared frailty model analysis, increased risk of recurrent fractures was associated with recipient female sex (HR = 1.74 [95% CI: 1.21, 2.51]) and history of diabetes (HR = 1.76 [95% CI: 1.17, 2.66]). <b>Discussion:</b> The results suggested that some risk factors for first fracture may not inform risk of recurrent fractures. As such, fracture risk should be assessed accordingly to optimize long-term care and implement preventive measures.</p>","PeriodicalId":20671,"journal":{"name":"Progress in Transplantation","volume":"33 1","pages":"16-24"},"PeriodicalIF":0.8,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a4/76/10.1177_15269248221145034.PMC9975818.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9077497","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Case Report of Excessive Inflammation After TACE That Mimicked Tumor Invasion of Adjacent Tissues.","authors":"Volkan Ince,&nbsp;Ibrahim Umar Garzali,&nbsp;Sertac Usta,&nbsp;Ramazan Kutlu,&nbsp;Sezai Yilmaz","doi":"10.1177/15269248221145037","DOIUrl":"https://doi.org/10.1177/15269248221145037","url":null,"abstract":"Liver transplantation is the most reliable treatment strategy for hepatocellular carcinoma (HCC) within certain selected criteria. Patients with HCC may not have access to liver donation at the appropriate time and this may result in fall out from the transplant list. To avoid this, bridging therapy has been recommended for patients with HCC to prevent progression of the tumor and to ensure that patients remain within the criteria of transplantation when the organ finally becomes available. Transcatheter arterial chemoembolization (TACE) is a commonly used bridging therapy in patients with HCC awaiting transplantation.","PeriodicalId":20671,"journal":{"name":"Progress in Transplantation","volume":"33 1","pages":"100-102"},"PeriodicalIF":0.8,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9091504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tacrolimus Formulation, Exposure Variability, and Outcomes in Kidney Transplant Recipients.","authors":"Elaine F Lai,&nbsp;Huong Thao Nguyen,&nbsp;Olusegun Famure,&nbsp;Yanhong Li,&nbsp;S Joseph Kim","doi":"10.1177/15269248221145044","DOIUrl":"https://doi.org/10.1177/15269248221145044","url":null,"abstract":"<p><strong>Introduction: </strong>Few studies have compared within-patient variability measures of tacrolimus trough levels by formulation and assessed within-patient variability on outcomes of kidney transplant recipients.</p><p><strong>Research questions: </strong>(1) To compare within-patient variability of trough levels when converting from twice-daily to once-daily tacrolimus using standard deviation, coefficient of variation, and intrapatient variability percent. (2) To use the 3 measures of variability to examine the relationship between tacrolimus once-daily within-patient variability and total graft failure (i.e., return to chronic dialysis, pre-emptive retransplant, death with graft function).</p><p><strong>Design: </strong>In this observational cohort study, within-patient variability of trough levels pre- and post-conversion from twice-daily to once-daily tacrolimus were compared using Wilcoxon matched-pairs signed-rank test. Graft outcomes were analyzed using Kaplan-Meier curves and multivariable Cox proportional hazards models.</p><p><strong>Results: </strong>In 463 patients, within-patient variability differences pre- and post-conversion of median standard deviation, coefficient of variation, and intrapatient variability percent were -0.16 (<i>P</i> = 0.09), -0.01 (<i>P</i> = 0.52), and -1.41 (<i>P</i> = 0.32), respectively. Post-conversion, every 1 unit increase in within-patient variability standard deviation and intrapatient variability percent and every 0.1 unit increase in the coefficient of variation was associated with an increased hazard ratio [1.19 (<i>P</i> = 0.004), 1.02 (<i>P</i> = 0.030), 1.13 (<i>P</i> = 0.001), respectively] of total graft failure. Post-conversion, within-patient variability above cohort medians using standard deviation and coefficient of variation had a significantly higher risk of total graft failure.</p><p><strong>Discussion: </strong>Under a program-wide conversion, no significant difference was observed in within-patient variability post-conversion from twice-daily to once-daily tacrolimus using the three measures of variability. High within-patient variability was associated with adverse transplant outcomes post-conversion.</p>","PeriodicalId":20671,"journal":{"name":"Progress in Transplantation","volume":"33 1","pages":"34-42"},"PeriodicalIF":0.8,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/93/13/10.1177_15269248221145044.PMC9968997.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9083973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using Community-Based Participatory Research to Create Animated Videos to Attenuate Disparities in Access to Kidney Transplant Information.","authors":"Liise K Kayler, Barbara Breckenridge, Cheryl Thomas, Sherry Brinser-Day, Esmeralda Sierra, Renee B Cadzow, Thomas H Feeley, Laurene Tumiel-Berhalter","doi":"10.1177/15269248221145031","DOIUrl":"10.1177/15269248221145031","url":null,"abstract":"<p><p><b>Introduction:</b> Community-based participatory research and animated video offer promising approaches to attenuate disparities in access to kidney transplant information. <b>Project Aims:</b> We refined an evidence-based animated video curriculum (Kidney Transplant and Donation Information Made Easy) designed for diverse individuals, that is currently being trialed to advance kidney transplant access among referred patients at a single transplant center, to further accommodate information needs in earlier stages of the path to transplant (pre-referral) and to enhance fit for Black and Hispanic people. <b>Design:</b> We describe formation of an academic-community partnership and the application of qualitative research methods and partnership discussions to refine the Kidney Transplant and Donation Information Made Easy videos. A simple content analysis was undertaken of intervention refinement transcriptions, minutes, and meeting notes. <b>Results:</b> We formed a community steering committee and advisory board of local members predominantly of minoritized race or ethnicity. Full engagement with community members is evident in the program's adaptation process. Essential refinement elements were adaptation of 17 original videos and iterative development of 8 new videos with the community, conducting parallel cognitive interviews of an expanded sample of stakeholders, maintaining the theoretical grounding of Elaboration Theory, communication/multimedia learning best practices, and self-efficacy framework, and doing Spanish-language translation. <b>Conclusions:</b> Applying community-based participatory research principles and qualitative methods, we produced a culturally grounded adaptation of the Kidney Transplant and Donation Information Made Easy videos that provides information about kidney transplantation from primary care to transplantation. This approach is likely to strengthen our community partnership and eventual community acceptance of the intervention during the implementation phase. Challenges were achieving consensus and adding Spanish-language translation.</p>","PeriodicalId":20671,"journal":{"name":"Progress in Transplantation","volume":"33 1","pages":"5-14"},"PeriodicalIF":0.8,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10997428/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9077498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Systematic Review and Meta-Analysis of Posttransplant Anemia With Overall Mortality and Cardiovascular Outcomes Among Kidney Transplant Recipients.","authors":"Poemlarp Mekraksakit,&nbsp;Natnicha Leelaviwat,&nbsp;Juthipong Benjanuwattra,&nbsp;Samapon Duangkham,&nbsp;Gaspar Del Rio-Pertuz,&nbsp;Charat Thongprayoon,&nbsp;Jakrin Kewcharoen,&nbsp;Boonphiphop Boonpheng,&nbsp;Camilo Pena,&nbsp;Wisit Cheungpasitporn","doi":"10.1177/15269248221145046","DOIUrl":"https://doi.org/10.1177/15269248221145046","url":null,"abstract":"<p><p><b>Introduction:</b> Posttransplant anemia is a common finding after kidney transplantation. A previous meta-analysis reported an association between anemia and graft loss. However, data on cardiovascular outcomes have not yet been reported. <b>Objective:</b> We conducted an updated meta-analysis to examine the association between posttransplant anemia and outcomes after transplantation including cardiovascular mortality in adult kidney transplant recipients. <b>Methods:</b> We comprehensively searched the databases of MEDLINE and EMBASE from inception to November 2021. Data from each study were combined using the random-effects model. Generic inverse variance method of DerSimonian and Laird was employed to calculate the risk ratios and 95% CIs. <b>Results:</b> Seventeen studies from August 2006 to April 2019 were included (16 463 kidney transplantation recipients). Posttransplant anemia was associated with overall mortality (pooled risk ratio = 1.72 [1.39, 2.13], <i>I</i>² = 56%), graft loss (pooled risk ratio = 2.28 [1.77, 2.93], <i>I</i>² = 94%), cardiovascular death (pooled risk ratio = 2.06 [1.35, 3.16], <i>I</i>² = 0%), and cardiovascular events (pooled risk ratio = 1.33 [1.10, 1.61], <i>I</i>² = 0%). Early anemia (≤6 months), compared with late anemia (>6 months), has higher risk of overall mortality and graft loss with a pooled risk ratio of 2.63 (95% CI 1.79-3.86; <i>I</i>² = 0%) and 2.96 (95% CI 2.29-3.82; <i>I</i>² = 0%), respectively. <b>Discussion:</b> In addition to increased risk of graft loss, our updated meta-analysis demonstrated that posttransplant anemia was significantly associated with poor outcomes after kidney transplantation including overall mortality, graft loss, cardiovascular death, and cardiovascular events. Future studies are required to assess the effects of treatment strategies for posttransplant anemia on posttransplant outcomes including cardiovascular mortality.</p>","PeriodicalId":20671,"journal":{"name":"Progress in Transplantation","volume":"33 1","pages":"78-89"},"PeriodicalIF":0.8,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9436221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}