Transplantation Reviews最新文献

{"title":"Barriers and facilitators of deceased organ donation among Muslims living globally: An integrative systematic review","authors":"Asmaa Al-Abdulghani ,&nbsp;Britzer Paul Vincent ,&nbsp;Gurch Randhawa ,&nbsp;Erica Cook ,&nbsp;Riadh Fadhil","doi":"10.1016/j.trre.2024.100874","DOIUrl":"10.1016/j.trre.2024.100874","url":null,"abstract":"<div><h3>Aim</h3><p>To identify the barriers and facilitators of deceased organ donation among the Muslim community living globally.</p></div><div><h3>Method</h3><p>A systematic search was undertaken in databases such as CINAHL, Medline with full text, Global Health and PsycINFO via EBSCO; Scopus via Elsevier; Web of Science via Clarivate; and PubMed via US National Library of Medicine National Institute of Health were used to retrieve the studies on the 31st of December 2023. Apart from these databases two other journals, the Saudi Journal of Kidney Diseases and Transplantation, and the Journal of Experimental and Clinical Transplantation were also used to search for relevant studies. Quantitative and qualitative studies that addressed the aim of the present review published from the 30th of April 2008 were included.</p></div><div><h3>Results</h3><p>Of the 10,474 studies, 95 studies were included in the review. The following five themes were generated based on narrative synthesis: 1) knowledge of organ donation, 2) willingness to donate, 3) community influence, 4) bodily influence, and 5) religious influence. While individuals view organ donation as a noble act, societal influences significantly impact their decision to register. Concerns include religious permissibility, potential misuse for commercial purposes, and the dignity and respect given to the deceased donor's body.</p></div><div><h3>Conclusions</h3><p>This review finds deceased organ donation decisions in this population are collective, influenced by religious views, and hindered by uncertainty. Interventional studies on strategies to address uncertainty could help us identify best practices for this population to improve deceased organ donation. Rather than an individual approach among this population, a whole-system approach, tailored-made evidence-guided community engagement could improve donation rates.</p></div>","PeriodicalId":48973,"journal":{"name":"Transplantation Reviews","volume":"38 4","pages":"Article 100874"},"PeriodicalIF":3.6,"publicationDate":"2024-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0955470X24000570/pdfft?md5=17dfd1c068f85138d6c7e54e7dcb56f3&pid=1-s2.0-S0955470X24000570-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141879962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Measuring patient-reported experience of solid organ transplantation healthcare: A scoping review of condition- and transplant-specific measures","authors":"Rebeka Jenkins ,&nbsp;Ben Rimmer ,&nbsp;Lorna Marson ,&nbsp;Andrew J. Fisher ,&nbsp;Linda Sharp ,&nbsp;Catherine Exley","doi":"10.1016/j.trre.2024.100872","DOIUrl":"10.1016/j.trre.2024.100872","url":null,"abstract":"<div><h3>Background</h3><p>Measures of patient experience are increasingly valued as key to healthcare quality assessment. We aimed to identify and describe publicly available measures assessing patient-reported experience of solid organ transplantation healthcare, and identify patient groups, healthcare settings, or aspects of patient experience underserved by existing measures.</p></div><div><h3>Methods</h3><p>We systematically searched MEDLINE, Embase, CINAHL, PsycINFO, Cochrane CENTRAL, Scopus and Web of Science from inception to 6th July 2023; supplemented with grey literature searches. Two reviewers independently screened search hits; outputs reporting patient-reported measures of multiple aspects of established solid organ transplantation healthcare were eligible. We abstracted measure context, characteristics, content (i.e., attributes of patient experience assessed), and development and validation processes.</p></div><div><h3>Results</h3><p>We identified nine outputs reporting eight measures of patient experience; these related only to kidney (<em>n</em> = 5) or liver (<em>n</em> = 3) transplantation, with no available measures relating to heart, lung, pancreas or intestinal transplantation. Of the identified measures, four were specific to solid organ transplant recipients. Measures sought to assess “patient satisfaction” (<em>n</em> = 4) and “patient experience” (n = 4) of healthcare. Measures mapped to between five and 16 of 20 attributes of patient experience, most often <em>Information and education</em>, <em>Communication,</em> and <em>Access to care</em> (all <em>n</em> = 7). Six measures reported a development process, only three reported a validation process.</p></div><div><h3>Conclusions</h3><p>Publicly available patient-reported measures of organ transplantation healthcare experiences are limited to kidney and liver transplantation. There is heterogeneity in measure context, characteristics, and content, and insufficient clarity concerning how well measures capture the specific experiences of transplant recipients. Formalised measures of patient experience, specific to solid organ transplantation, with transparent reporting of development and validity are needed.</p></div>","PeriodicalId":48973,"journal":{"name":"Transplantation Reviews","volume":"38 4","pages":"Article 100872"},"PeriodicalIF":3.6,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0955470X24000557/pdfft?md5=7aff97411bd1a3e8379bb5a877323594&pid=1-s2.0-S0955470X24000557-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141689867","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Simultaneous combined transplantation: Intricacies in immunosuppression management","authors":"Arnaud Del Bello ,&nbsp;Julien Vionnet ,&nbsp;Nicolas Congy-Jolivet ,&nbsp;Nassim Kamar","doi":"10.1016/j.trre.2024.100871","DOIUrl":"10.1016/j.trre.2024.100871","url":null,"abstract":"<div><p>Simultaneous combined transplantation (SCT), i.e. the transplantation of two solid organs within the same procedure, can be required when the patients develop more than one end-stage organ failure. The development of SCT over the last 20 years could only be possible thanks to progress in the surgical techniques and in the perioperative management of patients in an ageing population. Performing such major transplant surgeries from the same donor, in a short amount of time, and in critical pathophysiological conditions, is often considered to be counterbalanced by the immune benefits expected from these interventions. However, SCT includes a wide array of different transplant combinations, with each time a different immunological constellation. Recent research offers new insights into the immune mechanisms involved in these different settings. Progress in the understanding of these immunological intricacies help to address the optimal induction and maintenance immunosuppressive treatment strategies. In this review, we summarize the different immunological benefits according to the type of SCT performed. We also incorporate the main outcomes according to the immunological risk at transplantation, and the deleterious impact of preformed or de novo donor-specific antibodies (DSA) in the different types of SCT. Finally, we propose comprehensive and evidence-based induction and maintenance immunosuppression strategies guided by the type of SCT.</p></div>","PeriodicalId":48973,"journal":{"name":"Transplantation Reviews","volume":"38 4","pages":"Article 100871"},"PeriodicalIF":3.6,"publicationDate":"2024-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141694442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of islet alone or islets after kidney transplantation on quality of life in type 1 diabetes: A systematic review","authors":"Karim Gariani ,&nbsp;Andrea Peloso ,&nbsp;Vasiliki Galani ,&nbsp;Fadi Haidar ,&nbsp;Charles-Henri Wassmer ,&nbsp;Rohan Kumar ,&nbsp;Erika Holmgren Lacin ,&nbsp;Valerie Olivier ,&nbsp;Paco Prada ,&nbsp;Philippe Compagnon ,&nbsp;Ekaterine Berishvili ,&nbsp;Thierry Berney","doi":"10.1016/j.trre.2024.100870","DOIUrl":"10.1016/j.trre.2024.100870","url":null,"abstract":"<div><h3>Background</h3><p>Pancreatic islet transplantation for type 1 diabetes mellitus (T1DM) is efficacious in supressing severe hypoglycaemic episodes (SHE) and restoring glycaemic regulation, which are both pivotal in increasing health-related quality of life (HRQoL). Therefore, a systematic assessment of reports detailing HRQoL outcomes is warranted to better understand the benefits of islet transplantation. To this end, we performed a systematic review of the literature to assess the impact of islet transplantation on HRQoL in individuals with T1DM, whether as a standalone procedure (ITA) or following renal transplantation (IAK).</p></div><div><h3>Method</h3><p>All studies providing a quantitative assessment of HRQoL following ITA or IAK were included. Selected studies had to meet the following criteria: they had to (i) involve adult recipients of islet grafts for T1DM, (ii) use either generic or disease-specific QoL assessment tools, (iii) provide a comparative analysis of QoL metrics between the pre- and post-transplantation state or between the post-transplantation state and other pre-transplant patients or the general population.</p></div><div><h3>Results</h3><p>Seven studies that met the inclusion criteria provided data on 205 subjects. In the included studies, HRQoL was measured using both generic instruments, such as the 36-item Short Form Health Survey (SF-36) and the Health Status Questionnaire (HSQ) 2.0, and disease-specific instruments, such as the Diabetes Distress Scale (DDS), the Diabetes Quality of Life Questionnaire, and the Hypoglycaemia Fear Survey (HFS). These instruments cover physical, mental, social, or functional health dimensions. We found that pancreatic islet transplantation was associated with improvements in all HRQoL dimensions compared with the pre-transplant baseline.</p></div><div><h3>Conclusions</h3><p>Our systematic review demonstrates that islet transplantation significantly enhances quality of life in individuals with T1DM who are experiencing SHE. To our knowledge, this is the most extensive systematic review conducted to date, evaluating the impact of islet transplantation on HRQoL.</p></div>","PeriodicalId":48973,"journal":{"name":"Transplantation Reviews","volume":"38 4","pages":"Article 100870"},"PeriodicalIF":3.6,"publicationDate":"2024-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141452623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Brain natriuretic peptide and N-terminal pro b-type natriuretic peptide in kidney transplantation: More than just cardiac markers","authors":"Baris Afsar ,&nbsp;Rengin Elsurer Afsar ,&nbsp;Yasar Caliskan ,&nbsp;Krista L. Lentine","doi":"10.1016/j.trre.2024.100869","DOIUrl":"10.1016/j.trre.2024.100869","url":null,"abstract":"<div><p>Although kidney transplantation (KT) is the best treatment option for most patients with end-stage kidney disease (ESKD) due to reduced mortality, morbidity and increased quality of life, long- term complications such as chronic kidney allograft dysfunction (CKAD) and increased cardiovascular disease burden are still major challenges. Thus, routine screening of KT recipients (KTRs) is very important to identify and quantify risks and guide preventative measures. However, no screening parameter has perfect sensitivity and specificity, and there is unmet need for new markers. In this review, we evaluate brain natriuretic peptide (BNP) and N-terminal pro b-type natriuretic peptide (NT-proBNP) as promising markers for risk stratification in the kidney transplant recipients (KTRs). The usefulness of these markers are already proven in heart failure, hypertension, coronary artery disease. In the context of KT, evidence is emerging. BNP and NT-proBNP has shown to be associated with kidney function, graft failure, echocardiographic parameters, major cardiovascular events and mortality but the underlying mechanisms are not known. Although BNP and NT-proBNP interact with immune system, renin angiotensin system and sympathetic system; it is not known whether these interactions are responsible for the clinical findings observed in KTRs. Future studies are needed whether these biomarkers show clinical efficacy, especially with regard to hard outcomes such as major adverse cardiovascular events and graft dysfunction and whether routine implementation of these markers are cost effective in KTRs.</p></div>","PeriodicalId":48973,"journal":{"name":"Transplantation Reviews","volume":"38 4","pages":"Article 100869"},"PeriodicalIF":3.6,"publicationDate":"2024-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141444038","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring definitions of graft pancreatitis following pancreas transplantation: A scoping review","authors":"Stefano Partelli ,&nbsp;Valentina Andreasi ,&nbsp;Valentina Tomajer ,&nbsp;Domenico Tamburrino ,&nbsp;Rossana Caldara ,&nbsp;Paolo Rigotti ,&nbsp;Davide Catarinella ,&nbsp;Lorenzo Piemonti ,&nbsp;Massimo Falconi","doi":"10.1016/j.trre.2024.100861","DOIUrl":"https://doi.org/10.1016/j.trre.2024.100861","url":null,"abstract":"<div><p>Despite the clinical relevance of graft pancreatitis (GP) after pancreas transplantation (PT), a universally accepted definition is lacking. Aim of this scoping review was to provide a systematic overview of GP definitions reported in the literature. MEDLINE, Web of Science and Embase were searched for relevant articles. Prospective/retrospective studies reporting a GP definition were included. The included series (<em>n</em> = 20) used four main criteria (clinical, biochemical, radiological and pathological) to define GP. Overall, 9 studies defined GP using a single criterion (<em>n</em> = 8 biochemical, <em>n</em> = 1 pathological), 7 series using two criteria (<em>n</em> = 3 clinical + biochemical, <em>n</em> = 3 biochemical + radiological, <em>n</em> = 1 clinical + radiological), 3 series using three criteria (<em>n</em> = 3 clinical + biochemical + radiological), and 1 series using four criteria. Overall, 20 definitions of GP were found. GP rate was reported by 19 series and ranged between 0% and 87%. This scoping review confirms that a universally accepted definition of GP is absent, and there is no consensus on the criteria on which it should be grounded. Future research should focus on developing a validated definition of GP.</p></div>","PeriodicalId":48973,"journal":{"name":"Transplantation Reviews","volume":"38 4","pages":"Article 100861"},"PeriodicalIF":4.0,"publicationDate":"2024-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141308585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cytomegalovirus infection and cardiovascular outcomes in abdominal organ transplant recipients: A systematic review and meta-analysis","authors":"Panos Arvanitis ,&nbsp;Michel R. Davis ,&nbsp;Dimitrios Farmakiotis","doi":"10.1016/j.trre.2024.100860","DOIUrl":"https://doi.org/10.1016/j.trre.2024.100860","url":null,"abstract":"<div><h3>Introduction</h3><p>Despite advancements in Cytomegalovirus (CMV) management, its impact on graft function, mortality, and cardiovascular (CV) health of organ transplant recipients (OTR) remains a significant concern. We investigated the association between CMV infection and CV events (CVE) in organ (other than heart) transplant recipients.</p></div><div><h3>Methods</h3><p>We conducted a comprehensive literature search in PubMed and EMBASE, including studies that reported on CMV infection or disease and post-transplantation CVE. Studies of heart transplant recipients were excluded.</p></div><div><h3>Results</h3><p>We screened 3875 abstracts and 12 clinical studies were included in the final analysis, mainly in kidney and liver transplant recipients. A significant association was observed between CMV infection and an increased risk of CVE, with a pooled unadjusted hazard ratio (HR) of 1.99 (95% Confidence Intervals [CI] 1.45–2.73) for CMV infection and 1.59 (95% CI 1.21–2.10) for CMV disease. Pooled adjusted HR were 2.17 (95% CI 1.47–3.20) and 1.77 (95% CI 0.83–3.76), respectively. Heterogeneity was low (I² = 0%) for CMV infection, suggesting consistent association across studies, and moderate-to-high for CMVdisease (I² = 50% for unadjusted, 53% for adjusted HR).</p></div><div><h3>Discussion</h3><p>We found a significant association between CMV infection and CV risk in abdominal OTR, underscoring the importance of proactive CMV surveillance and early treatment. Future research should aim for more standardized methodologies to fully elucidate the relationship between CMV and CV outcomes, potentially informing novel preventive and therapeutic strategies that could benefit the CV health of OTR.</p></div>","PeriodicalId":48973,"journal":{"name":"Transplantation Reviews","volume":"38 4","pages":"Article 100860"},"PeriodicalIF":4.0,"publicationDate":"2024-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141164530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A holistic review of sodium intake in kidney transplant patients: More questions than answers","authors":"Baris Afsar ,&nbsp;Rengin Elsurer Afsar ,&nbsp;Yasar Caliskan ,&nbsp;Krista L. Lentine","doi":"10.1016/j.trre.2024.100859","DOIUrl":"https://doi.org/10.1016/j.trre.2024.100859","url":null,"abstract":"<div><p>Kidney transplantation (KT) is the best treatment option for end-stage kidney disease (ESKD). Acute rejection rates have decreased drastically in recent years but chronic kidney allograft disease (CKAD) is still an important cause of allograft failure and return to dialysis. Thus, there is unmet need to identify and reverse the cause of CKAD. Additionally, cardiovascular events after KT are still leading causes of morbidity and mortality. One overlooked potential contributor to CKAD and adverse cardiovascular events is increased sodium/salt intake in kidney transplant recipients (KTRs). In general population, the adverse effects of high sodium intake are well known but in KTRs, there is a paucity of evidence despite decades of experience with KT. Limited research showed that sodium intake is high in most KTRs. Moreover, excess sodium intake is associated with elevated blood pressure and albuminuria in some studies involving KTRs. There is also experimental evidence suggesting that increased sodium intake is associated with histologic graft damage.</p><p>Critical knowledge gaps still remain, including the exact amount of sodium restriction needed in KTRs to optimize outcomes and allograft survival. Additionally, best methods to measure sodium intake and practices to follow-up are not clarified in KTRs. To meet these deficits, prospective long term studies are warranted in KTRs. Moreover, preventive measures must be determined and implemented both at individual and societal levels to achieve sodium restriction in KTRs.</p></div>","PeriodicalId":48973,"journal":{"name":"Transplantation Reviews","volume":"38 3","pages":"Article 100859"},"PeriodicalIF":4.0,"publicationDate":"2024-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140918105","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A systematic review of psychosocial and sex-based contributors to gender disparities in the United States across the steps towards kidney transplantation","authors":"Shelby A. Smout ,&nbsp;Emily M. Yang ,&nbsp;Dinushika Mohottige ,&nbsp;Camilla W. Nonterah","doi":"10.1016/j.trre.2024.100858","DOIUrl":"https://doi.org/10.1016/j.trre.2024.100858","url":null,"abstract":"<div><h3>Introduction</h3><p>Persistent findings suggest women and patients identified as “female” are less likely to receive a kidney transplant. Furthermore, the limited research on transplantation among transgender and gender diverse people suggests this population is susceptible to many of the same psychosocial and systemic barriers.</p></div><div><h3>Objective</h3><p>This review sought to 1) highlight terminology used to elucidate gender disparities, 2) identify barriers present along the steps to transplantation, and 3) summarize contributors to gender disparities across the steps to transplantation.</p></div><div><h3>Methods</h3><p>A systematic review of gender and sex disparities in the steps towards kidney transplantation was conducted in accordance with PRISMA guidelines across four social science and public health databases from 2005 to 23.</p></div><div><h3>Results</h3><p>The search yielded 1696 initial results, 33 of which met inclusion criteria. A majority of studies followed a retrospective cohort design (<em>n</em> = 22, 66.7%), inconsistently used gender and sex related terminology (<em>n</em> = 21, 63.6%), and reported significant findings for gender and sex disparities within the steps towards transplantation (<em>n</em> = 28, 84.8%). Gender disparities among the earlier steps were characterized by patient-provider communication and perception of medical suitability whereas disparities in the later steps were characterized by differential outcomes based on older age, an above average BMI, and Black racial identity. Findings for transgender patients pointed to issues computing eGFR and the need for culturally tailored care.</p></div><div><h3>Discussion</h3><p>Providers should be encouraged to critically examine the diagnostic criteria used to determine transplant eligibility and adopt practices that can be culturally tailored to meet the needs of patients.</p></div>","PeriodicalId":48973,"journal":{"name":"Transplantation Reviews","volume":"38 3","pages":"Article 100858"},"PeriodicalIF":4.0,"publicationDate":"2024-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140902404","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immunosuppressive drug combinations after kidney transplantation and post-transplant diabetes: A systematic review and meta-analysis","authors":"Laia Oliveras ,&nbsp;Ana Coloma ,&nbsp;Nuria Lloberas ,&nbsp;Luis Lino ,&nbsp;Alexandre Favà ,&nbsp;Anna Manonelles ,&nbsp;Sergi Codina ,&nbsp;Carlos Couceiro ,&nbsp;Edoardo Melilli ,&nbsp;Adnan Sharif ,&nbsp;Manfred Hecking ,&nbsp;Martina Guthoff ,&nbsp;Josep M. Cruzado ,&nbsp;Julio Pascual ,&nbsp;Nuria Montero","doi":"10.1016/j.trre.2024.100856","DOIUrl":"https://doi.org/10.1016/j.trre.2024.100856","url":null,"abstract":"<div><p>Post-transplant diabetes mellitus (PTDM) is a frequent complication after kidney transplantation (KT). This systematic review investigated the effect of different immunosuppressive regimens on the risk of PTDM. We performed a systematic literature search in MEDLINE and CENTRAL for randomized controlled trials (RCTs) that included KT recipients with any immunosuppression and reported PTDM outcomes up to 1 October 2023. The analysis included 125 RCTs. We found no differences in PTDM risk within induction therapies. In de novo KT, there was an increased risk of developing PTDM with tacrolimus versus cyclosporin (RR 1.71, 95%CI [1.38-2.11]). No differences were observed between tacrolimus+mammalian target of rapamycin inhibitor (mTORi) and tacrolimus+MMF/MPA, but there was a tendency towards a higher risk of PTDM in the cyclosporin+mTORi group (RR 1.42, 95%CI [0.99-2.04]). Conversion from cyclosporin to an mTORi increased PTDM risk (RR 1.89, 95%CI [1.18-3.03]). De novo belatacept compared with a calcineurin inhibitor resulted in 50% lower risk of PTDM (RR 0.50, 95%CI [0.32-0.79]). Steroid avoidance resulted in 31% lower PTDM risk (RR 0.69, 95%CI [0.57-0.83]), whereas steroid withdrawal resulted in no differences. Immunosuppression should be decided on an individual basis, carefully weighing the risk of future PTDM and rejection.</p></div>","PeriodicalId":48973,"journal":{"name":"Transplantation Reviews","volume":"38 3","pages":"Article 100856"},"PeriodicalIF":4.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140880107","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}