Transplantation Reviews最新文献

{"title":"Living donor robotic-assisted kidney transplant compared to traditional living donor open kidney transplant. Where do we stand now? A systematic review and meta-analysis","authors":"Mario A. O'Connor-Cordova ,&nbsp;Alan G. Ortega-Macias ,&nbsp;Juan P. Sancen-Herrera ,&nbsp;Francisco Altamirano-Lamarque ,&nbsp;Alexis Vargas del Toro ,&nbsp;Andres Inzunza Martin del Campo ,&nbsp;Pia Canal-Zarate ,&nbsp;Bharat Kumar Peddinani ,&nbsp;Fernando Gonzalez-Zorrilla ,&nbsp;Mario O'Connor Juarez","doi":"10.1016/j.trre.2023.100789","DOIUrl":"10.1016/j.trre.2023.100789","url":null,"abstract":"<div><h3>Background</h3><p>Renal transplant<span> is the standard of care for patients with end-stage renal disease (ESRD). Robotic-assisted kidney transplant (RAKT) has emerged as a safe minimally invasive approach with a lower complication rate than open kidney transplant (OKT). Concerns regarding ischemia times and graft function are still a matter of debate.</span></p></div><div><h3>Methods</h3><p>Following PRISMA guidelines and PROSPERO registration CRD42023413774, a systematic review was performed in March 2023 on RAKT compared to OKT. Primary outcomes of interest were surgical times, ischemia times, blood loss, complication rates, and graft function. Data were analyzed using R version 4.2.2.</p></div><div><h3>Results</h3><p><span>A total of nine studies comparing living donor RAKT to living donor OKT were included, totaling 1477 patients, out of which 508 underwent RAKT and 969 OKT. RAKT cases were highly selected as depicted in the manuscript. Cumulative analysis showed significantly longer total ischemic time<span><span> (MD = 16.51; 95% CI = [9.86–23.16]) and rewarming ischemia time (MD = 11.24; 95% CI = [−0.46–22.01]) in RAKT group. No differences were found in total procedure time and time to complete anastomoses. Blood loss and transfusion rate were lower in RAKT group (MD = −53.68; 95% CI = [−89.78; −17.58]) and (RR = 0.29; 95% CI = [0.14; 0.57]), respectively. The meta-analysis revealed a lower rate of </span>surgical site infection<span><span> (SSI) (RR = 0.31; 95% CI = [0.19–0.52]) and symptomatic lymphocele (RR = 0.16; 95% CI = [0.06–0.43]) in RAKT. No difference in </span>ileus rate was found. Pain scores were significantly lower in the RAKT group (MD = -1.14; 95% CI = [−1.59 - -0.69]; </span></span></span><em>p</em><span> ≤0.01). No difference in length of stay and hospital readmission were evidenced. Delayed graft function<span> (DGF) and acute rejection rates were not different between interventions groups (RR =1.23; 95% CI = [0.40–3.74]) and (RR =0.96; 95% CI = [0.55–1.70]), respectively. No difference between groups in early graft outcomes are evident.</span></span></p></div><div><h3>Conclusions</h3><p>Our analysis suggests that RAKT is a minimally invasive, safe, and feasible procedure. It is associated with a lower complication rate and similar intraoperative, perioperative, and postoperative outcomes. Further quality studies are needed to confirm these findings.</p></div>","PeriodicalId":48973,"journal":{"name":"Transplantation Reviews","volume":"37 4","pages":"Article 100789"},"PeriodicalIF":4.0,"publicationDate":"2023-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10395530","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":"Executive summary of the consensus statement of the group for the study of infection in transplantation and other immunocompromised host (GESITRA-IC) of the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC) on the treatment of SARS-CoV-2 infection in solid organ transplant recipients","authors":"Sabina Herrera ,&nbsp;Jose M Aguado ,&nbsp;Francisco Javier Candel ,&nbsp;Elisa Cordero ,&nbsp;Beatriz Domínguez-Gil ,&nbsp;Mario Fernández-Ruiz ,&nbsp;Ibai Los Arcos ,&nbsp;Òscar Len ,&nbsp;M. Ángeles Marcos ,&nbsp;Elena Muñez ,&nbsp;Patricia Muñoz ,&nbsp;Isabel Rodríguez-Goncer ,&nbsp;Javier Sánchez-Céspedes ,&nbsp;Maricela Valerio ,&nbsp;Marta Bodro","doi":"10.1016/j.trre.2023.100788","DOIUrl":"10.1016/j.trre.2023.100788","url":null,"abstract":"","PeriodicalId":48973,"journal":{"name":"Transplantation Reviews","volume":"37 4","pages":"Article 100788"},"PeriodicalIF":4.0,"publicationDate":"2023-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10018196","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":"Immunosuppression of HLA identical living-donor kidney transplant recipients: A systematic review","authors":"María José Pérez-Sáez ,&nbsp;Núria Montero ,&nbsp;Laia Oliveras ,&nbsp;Dolores Redondo-Pachón ,&nbsp;David Martínez-Simón ,&nbsp;Daniel Abramovicz ,&nbsp;Umberto Maggiore ,&nbsp;Christophe Mariat ,&nbsp;Geir Mjoen ,&nbsp;Gabriel C. Oniscu ,&nbsp;Licia Peruzzi ,&nbsp;Mehmet Sükrü Sever ,&nbsp;Bruno Watschinger ,&nbsp;Arzu Velioglu ,&nbsp;Erol Demir ,&nbsp;Ilaria Gandolfini ,&nbsp;Rachel Hellemans ,&nbsp;Luuk Hilbrands ,&nbsp;Julio Pascual ,&nbsp;Marta Crespo","doi":"10.1016/j.trre.2023.100787","DOIUrl":"10.1016/j.trre.2023.100787","url":null,"abstract":"<div><h3>Background</h3><p><span>Kidney transplant (KT) recipients of </span>HLA<span> identical siblings (HLAid) have lower immunological risk, but there are no specific recommendations for immunosuppression. Our aim was to analyze evidence about results from HLAid living-donor recipients under different immunosuppression in the current era of immunological risk assessment.</span></p></div><div><h3>Methods</h3><p>Systematic review of studies describing associations between outcomes of HLAid living-donor KT recipients according to their immunological risk and applied immunosuppression.</p></div><div><h3>Results</h3><p>From 1351 studies, 16 (5636 KT recipients) were included in the analysis. All studies were retrospective, ten comparing immunosuppression strategies, and six immunological risk strata. Of those ten, six studies were published in 1990 or earlier and only three included tacrolimus<span>. The evidence is poor, and the inclusion of calcineurin inhibitors does not demonstrate better results. Furthermore, only few studies describe different immunosuppression regimens according to the patient immunological risk and, in general, they do not include the assessment with new solid phase assays.</span></p></div><div><h3>Conclusions</h3><p>There are no studies analyzing the association of outcomes of HLAid KT recipients with current immunological risk tools. In the absence of evidence, no decision or proposal of immunosuppression adapted to modern immunological risk assessment can be made currently by the Descartes Working Group.</p></div>","PeriodicalId":48973,"journal":{"name":"Transplantation Reviews","volume":"37 4","pages":"Article 100787"},"PeriodicalIF":4.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10135715","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":"Diagnostic accuracy of brain natriuretic peptide and N-terminal-pro brain natriuretic peptide to detect complications of cardiac transplantation in adults: A systematic review and meta-analysis","authors":"Victor Zhu ,&nbsp;Luke A. Perry ,&nbsp;Mark Plummer ,&nbsp;Reny Segal ,&nbsp;Julian Smith ,&nbsp;Zhengyang Liu","doi":"10.1016/j.trre.2023.100774","DOIUrl":"10.1016/j.trre.2023.100774","url":null,"abstract":"<div><h3>Background</h3><p><span>We aimed to evaluate the utility of BNP and NT-proBNP in identifying adverse recipient outcomes following </span>cardiac transplantation.</p></div><div><h3>Methods</h3><p>We searched MEDLINE (Ovid), Embase (Ovid), and the Cochrane Library from inception to February 2023. We included studies reporting associations between BNP or NT-proBNP and adverse outcomes following cardiac transplantation in adults. We calculated standardised mean differences (SMD) with 95% confidence intervals (CI); or confusion matrices with sensitivities and specificities. Where meta-analysis was inappropriate, studies were analysed descriptively.</p></div><div><h3>Results</h3><p><span>Thirty-two studies involving 2,297 cardiac transplantation recipients were included. We report no significant association between BNP or NT-proBNP and significant acute cellular rejection of grade 3A or higher (SMD 0.40, 95% CI -0.06–0.86) as defined by the latest 2004 International Society for Heart and Lung Transplantation Guidelines. We also report no strong associations between BNP or NT-proBNP and </span>cardiac allograft vasculopathy<span> or antibody mediated rejection.</span></p></div><div><h3>Conclusion</h3><p>In isolation, serum BNP and NT-proBNP lack sufficient sensitivity and specificity to reliably predict adverse outcomes following cardiac transplantation.</p></div>","PeriodicalId":48973,"journal":{"name":"Transplantation Reviews","volume":"37 3","pages":"Article 100774"},"PeriodicalIF":4.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10293615","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":"Inhibitory innate receptors and their potential role in transplantation","authors":"Karina Lima ,&nbsp;Guilherme T. Ribas ,&nbsp;Leonardo V. Riella ,&nbsp;Thiago J. Borges","doi":"10.1016/j.trre.2023.100776","DOIUrl":"10.1016/j.trre.2023.100776","url":null,"abstract":"<div><p><span><span>The regulatory arm of the immune system plays a crucial role in maintaining immune tolerance<span><span> and preventing excessive immune responses. Immune regulation comprises various regulatory cells and molecules that work together to suppress or regulate immune responses. The </span>programmed cell death protein 1 (PD-1) and cytotoxic T lymphocyte-associated protein 4 (CTLA-4) are examples of inhibitory receptors that counteract activating signals and fine-tune immune responses. While most of the discoveries of immune regulation have been related to </span></span>T cells and the adaptive immune system, the innate arm of the immune system also has a range of inhibitory receptors that can counteract activating signals and suppress the effector immune responses. Targeting these innate inhibitory receptors may provide a complementary therapeutic approach in several immune-related conditions, including transplantation. In this review, we will explore the potential role of innate inhibitory receptors in controlling </span>alloimmunity<span> during solid organ transplantation.</span></p></div>","PeriodicalId":48973,"journal":{"name":"Transplantation Reviews","volume":"37 3","pages":"Article 100776"},"PeriodicalIF":4.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10275604","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":"Current and future role of double-lung transplantation for bilateral lung cancer","authors":"Jeeyeon Lee ,&nbsp;Samuel J. Schellenberg ,&nbsp;Liam Il-Young Chung ,&nbsp;Ankit Bharat ,&nbsp;Young Kwang Chae","doi":"10.1016/j.trre.2023.100772","DOIUrl":"10.1016/j.trre.2023.100772","url":null,"abstract":"<div><p>Technological advances have progressively enhanced the survival rate of lung transplant recipients and expanded its indications for various diseases, including the recent coronavirus disease 2019 (COVID-19). However, according to the International Society for Heart and Lung Transplantation, lung cancer constituted a mere 0.1% of the indications for lung transplantation over the past two decades. This statistic has remained stagnant, and numerous lung cancer patients continue to be excluded from lung transplantation candidacy. Contrary to the general exclusion of lung cancer patients from transplantation, the post-transplant survival rate for these patients is not inferior to that of patients with non-cancerous diseases. Furthermore, lung transplantation may offer curative treatment for patients with bilateral lung cancer whose respiratory insufficiency has advanced independently of cancer progression. This review aims to elucidate and examine the role of double lung transplantation (DLT) in bilateral lung cancer. We summarize the established indications for lung transplantation, appropriate histologic or molecular subtypes of lung cancer for transplantation, technical advances to minimize recurrence, post-DLT survival outcomes for lung cancer patients, and related translational research. We suggest that although DLT for bilateral lung cancer presents challenges, it may be considered a potential treatment option in select circumstances.</p></div>","PeriodicalId":48973,"journal":{"name":"Transplantation Reviews","volume":"37 3","pages":"Article 100772"},"PeriodicalIF":4.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10276654/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9914636","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":"Treatment of hepatocellular carcinoma with macroscopic vascular invasion: A systematic review and network meta-analysis","authors":"Francisco Tustumi ,&nbsp;Fabricio Ferreira Coelho ,&nbsp;Daniel de Paiva Magalhães ,&nbsp;Sérgio Silveira Júnior ,&nbsp;Vagner Birk Jeismann ,&nbsp;Gilton Marques Fonseca ,&nbsp;Jaime Arthur Pirola Kruger ,&nbsp;Luiz Augusto Carneiro D'Albuquerque ,&nbsp;Paulo Herman","doi":"10.1016/j.trre.2023.100763","DOIUrl":"10.1016/j.trre.2023.100763","url":null,"abstract":"<div><h3>Background</h3><p>This study aimed to evaluate the outcomes of different treatments for patients with hepatocellular carcinoma (HCC) and macroscopic vascular invasion.</p></div><div><h3>Methods</h3><p><span>A systematic review<span><span> and meta-analysis of comparative studies was performed to evaluate various treatment modalities for HCC with macroscopic vascular invasion, including liver resection (LR), </span>liver transplantation<span> (LT), transarterial chemoembolization<span> (TACE), transarterial radioembolization (TARE), radiotherapy (RT), </span></span></span></span>radiofrequency ablation<span> (RFA), and antineoplastic systemic therapy (AnST).</span></p></div><div><h3>Results</h3><p>After applying the selection criteria, 31 studies were included. The surgical resection (SR) group (including LR and LT) had a similar mortality rate to the non-surgical resection (NS) group (RD = −0.01; 95% CI -0.05 to 0.03). The SR group had a higher rate of complications (RD = 0.06; 95% CI 0.00 to 0.12) but a higher 3-year overall survival (OS) rate than the NS group (RD = 0.12; 95% CI 0.05 to 0.20). The network analysis revealed that the overall survival was lower in the AnST group. LT and LR had similar survival benefits. The meta-regression suggested that SR has a greater impact on the survival of patients with impaired liver function.</p></div><div><h3>Discussion</h3><p>Most likely, LT has a significant impact on long-term survival and consequently would be a better option for HCC with macroscopic vascular invasion in patients with impaired liver function. LT and LR offer a higher chance of long-term survival than NS alternatives, although LR and LR are associated with a higher risk of procedure-related complications.</p></div>","PeriodicalId":48973,"journal":{"name":"Transplantation Reviews","volume":"37 3","pages":"Article 100763"},"PeriodicalIF":4.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10293591","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":"Rescue liver transplantation after post-hepatectomy acute liver failure: A systematic review and pooled analysis","authors":"Roberta Angelico ,&nbsp;Leandro Siragusa ,&nbsp;Matteo Serenari ,&nbsp;Irene Scalera ,&nbsp;Emanuele Kauffman ,&nbsp;Quirino Lai ,&nbsp;Alessandro Vitale ,&nbsp;on behalf of the Italian Chapter of IHPBA (AICEP, Associazione Italiana di Chirurgia Epatobilio-Pancreatica)","doi":"10.1016/j.trre.2023.100773","DOIUrl":"10.1016/j.trre.2023.100773","url":null,"abstract":"<div><h3>Background</h3><p><span><span><span>Post-hepatectomy liver failure is a severe complication after major liver resection and is associated with a high mortality rate. Nevertheless, there is no effective treatment for </span>severe liver failure. In such a setting, rescue </span>liver transplantation (LT) is used only in extraordinary cases with unclear results. This </span>systematic review aims to define indication of LT in post-hepatectomy liver failure and post-LT outcomes, in terms of patient and disease-free survivals, to assess the procedure's feasibility and effectiveness.</p></div><div><h3>Methods</h3><p>A systematic review of all English language full-text articles published until September 2022 was conducted. Inclusion criteria were articles describing patients undergoing LT for post-hepatectomy liver failure after liver resection, which specified at least one outcome of interest regarding patient/graft survival, postoperative complications<span>, tumour recurrence and cause of death. A pseudo-individual participant data meta-analysis was performed to analyse data. Study quality was assessed with MINORS system. PROSPERO CRD42022349358.</span></p></div><div><h3>Results</h3><p><span>Postoperative complication rate was 53.6%. All patients transplanted for benign indications survived. For malignant tumours, 1-, 3- and 5-year overall survival was 94.7%, 82.1% and 74.6%, respectively. The causes of death were tumour recurrence in 83.3% of cases and infection-related in 16.7% of LT recipients. At Cox regression, being transplanted for unconventional malignant indications (colorectal liver metastasis, cholangiocarcinoma) was a risk factor for death HR = 8.93 (95%CI = 1.04–76.63; </span><em>P</em>-value = 0.046). Disease-free survival differs according to different malignant tumours (P-value = 0.045).</p></div><div><h3>Conclusions</h3><p>Post-hepatectomy liver failure is an emergent indication for rescue LT, but it is not universally accepted. In selected patients, LT can be a life-saving procedure with low short-term risks. However, special attention must be given to long-term oncological prognosis before proceeding with rescue LT in an urgent setting, considering the severity of liver malignancy, organ scarcity, the country's organ allocation policies and the resource of living-related donation.</p></div>","PeriodicalId":48973,"journal":{"name":"Transplantation Reviews","volume":"37 3","pages":"Article 100773"},"PeriodicalIF":4.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9914633","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":"Serum uric acid levels in kidney transplant recipients: A cause for concern? A review of recent literature","authors":"Uyi Jefferson Imasuen,&nbsp;Kurtis J. Swanson,&nbsp;Sandesh Parajuli","doi":"10.1016/j.trre.2023.100775","DOIUrl":"10.1016/j.trre.2023.100775","url":null,"abstract":"<div><p>The impact of elevated serum uric acid<span><span> levels i.e., hyperuricemia<span>, on native and transplant chronic kidney disease progression has been debated. This literature review presents an analysis of multiple studies exploring the relationship between serum uric acid levels and </span></span>kidney transplant<span><span> outcomes. The review includes a summary of the pathophysiology of hyperuricemia and gout, a review of urate-lowering </span>therapies, and an appraisal of multiple studies examining the association or lack thereof between serum uric acid level and kidney transplant outcomes. Based on these studies, elevated serum uric acid levels may contribute to CKD progression in kidney transplant recipients. In this review, we also summarize current literature to highlight risk factors associated with hyperuricemia as well as the need for further investigation to monitor and manage hyperuricemia in kidney transplant recipients.</span></span></p></div>","PeriodicalId":48973,"journal":{"name":"Transplantation Reviews","volume":"37 3","pages":"Article 100775"},"PeriodicalIF":4.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9920992","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":"Bariatric surgery improves access to renal transplantation and is safe in renal failure as well as after transplantation: A systematic review and meta-analysis","authors":"Sherwin Fernando ,&nbsp;Jonny Varma ,&nbsp;Fungai Dengu ,&nbsp;Vinod Menon ,&nbsp;Shafi Malik ,&nbsp;John O'Callaghan","doi":"10.1016/j.trre.2023.100777","DOIUrl":"10.1016/j.trre.2023.100777","url":null,"abstract":"<div><h3>Introduction</h3><p><span><span>Effective workup and listing of end-stage renal disease (ESRD) patients for renal transplantation, often with multiple co-morbidities, poses a challenge for transplant teams. Obesity is a common co-morbidity associated with </span>adverse outcomes<span><span> in ESRD and kidney transplant (KT) recipients. </span>Bariatric<span><span> and metabolic surgery (BMS) has long been established as a safe and effective treatment for </span>morbid obesity. In this study, the authors aimed to evaluate the strength of evidence for both the efficacy and safety of </span></span></span>bariatric surgery<span> in patients with ESRD or kidney transplantation.</span></p></div><div><h3>Methods</h3><p>A literature search was performed using key terms including “transplantation”, “kidney”, “renal”, “obesity”, and “bariatric”. Databases searched include MEDLINE, EMBASE and Web of Science from inception to date (April 2021). Methodological quality was assessed using the Newcastle-Ottawa tool. Selected articles were then categorised into patients awaiting waiting list acceptance, patients awaiting transplantation, patients undergoing simultaneous BMS + KT and patients undergoing BMS following a previous renal transplant. Summary effects are presented with a level of statistical significance and 95% Confidence Intervals.</p></div><div><h3>Results</h3><p>A total of 28 articles were selected following the literature search. Fourteen studies on patients awaiting listing (<em>n</em> = 1903), nine on patients on the KT waiting list (<em>n</em> = 196), a single study on simultaneous BMS and KT and ten studies on patients undergoing BMS following KT (<em>n</em><span> = 198). Mean change in BMI for patients awaiting listing was −11.3 kg/m</span>² (95%CI: −15.3 to −7.3, <em>p</em> &lt; 0.001), mean change in BMI for patients listed for KT was −11.2 kg/m 2(95%CI: −12.9 to −9.5, p 0.001) and mean change for patients with prior KT was −11.0 kg/m² (95%CI: −7.09 to −14.9, <em>p</em> &lt; 0.001). The combined mortality rate for patients who had undergone both BMS and KT was 4% (<em>n</em> = 15).</p></div><div><h3>Discussion</h3><p>This review demonstrates BMS is both safe and efficacious in patients with ESRD prior to KT and in those post KT. It would enable difficult-to-list obese recipients the possibility to undergo transplantation and should be considered as part of the work up process.</p></div>","PeriodicalId":48973,"journal":{"name":"Transplantation Reviews","volume":"37 3","pages":"Article 100777"},"PeriodicalIF":4.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9972596","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}