Transplantation Reviews最新文献

{"title":"The association between tacrolimus exposure and tremor, headache and insomnia in adult kidney transplant recipients: A systematic review","authors":"Catherine P. King ,&nbsp;Amelia R. Cossart ,&nbsp;Nicole M. Isbel ,&nbsp;Scott B. Campbell ,&nbsp;Christine E. Staatz","doi":"10.1016/j.trre.2023.100815","DOIUrl":"10.1016/j.trre.2023.100815","url":null,"abstract":"<div><h3>Purpose</h3><p>Tremor, headache and insomnia have been linked to the immunosuppressant, tacrolimus. The aim of this systematic review was to determine if there is a correlation between tacrolimus exposure and new-onset tremor, headache and insomnia experienced by adult kidney transplant recipients.</p></div><div><h3>Methods</h3><p>PubMed, Embase, Cochrane Library and CINAHL databases were searched up to 11 April 2023 for published studies which reported on tacrolimus exposure in adult kidney transplant recipients, alongside information on treatment-emergent neurologic manifestations, including tremor, headache and insomnia. Review articles, case studies, conference abstracts and articles not published in English in peer-reviewed journals were excluded. The Physiotherapy Evidence Database and Newcastle-Ottawa Quality Assessment Scales were used to assess risk of bias. Extracted data was analysed via a narrative synthesis.</p></div><div><h3>Results</h3><p>Eighteen studies involving 4030 patients in total were included in the final analysis. These comprised five randomised control trials and thirteen observational studies. Studies failed to find significant association between tacrolimus trough concentrations in whole blood and the incidence of neurologic side effects such as tremor, headache and insomnia; however, in one study the incidence of toxicity requiring a dose reduction increased with increasing, supratherapeutic targeted levels. Females, especially Black females, and older age were positively associated with the prevalence of neurologic adverse effects. Results were conflicting regarding whether extended-release formulations were associated with fewer neurologic complications than immediate-release formulations.</p></div><div><h3>Conclusion</h3><p>The varied study designs and criteria for reporting tremor, headache and insomnia impacted on the quality of the data for exploring the relationship between tacrolimus exposure and the onset of neurologic manifestations experienced after kidney transplantation. Studies that examine defined neurologic complications as the primary outcome, and that consider novel markers of tacrolimus exposure while assessing the potential contribution of multiple covariate factors, are required.</p></div>","PeriodicalId":48973,"journal":{"name":"Transplantation Reviews","volume":"38 1","pages":"Article 100815"},"PeriodicalIF":4.0,"publicationDate":"2023-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0955470X23000691/pdfft?md5=fbe925638ee6638f7d56cc782a925b43&pid=1-s2.0-S0955470X23000691-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138563387","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":"Disparities in kidney transplantation accessibility among immigrant populations in Europe: A systematic review and meta-analysis","authors":"Pieter A.H. van Overdijk ,&nbsp;Alessandra A. Grossi ,&nbsp;Céline H. van Delft ,&nbsp;Nichon E. Jansen ,&nbsp;Martijn W.F. van den Hoogen ,&nbsp;David Paredes-Zapata","doi":"10.1016/j.trre.2023.100814","DOIUrl":"10.1016/j.trre.2023.100814","url":null,"abstract":"<div><h3>Background and objectives</h3><p>Disparities in access to healthcare for patients with an immigration background are well-known. The aim of this study was to determine whether disparities among immigrant populations translate into a relative difference in the number of kidney transplants (KT) performed in documented immigrant patients (first and second generation) relative to native-born patients in Europe.</p></div><div><h3>Methods</h3><p>A literature search was performed in PubMed from inception to 11-10-2022. Studies were eligible if: (1) written in English, (2) included immigrant and native-born KT patients, (3) performed in countries registered as Council of Europe members, (4) focused on documented first- and second-generation immigrant populations [1]. Systematic reviews, literature reviews, and case reports or articles about emigration, non-KT, and undocumented immigrants were excluded. The outcome measurement was a relative percentage of KTs to the total population per 100.000 residents. By dividing the immigrant percentages by the native-born resident percentages, the odds ratio (OR) was calculated in a meta-analysis. The risk of bias was assessed; articles with high risk of bias were excluded in a second meta-analysis.</p></div><div><h3>Results</h3><p>Out of 109 articles, 5 were included (<em>n</em> = 24,614). One Italian study (<em>n</em> = 24,174) had a ratio below 1, being 0.910 (95%CI 0.877–0.945). The other four articles (<em>n</em> = 196, <em>n</em> = 283, <em>n</em> = 77, <em>n</em> = 119) had ratios above 1: 1.36 (95%CI 0.980–1.87), 2.04 (95%CI 1.56–2.68), 2.23 (95%CI 1.53–3.25) and 2.64 (95%CI 1.68–4.15). After performing a meta-analysis, the OR did not show a significant difference: 1.68 (95%CI 1.03–2.75). After bias correction, this remained unchanged: 1.78 (95%CI 0.961–3.31).</p></div><div><h3>Conclusions</h3><p>In our meta-analysis we did not find a significant difference in the relative number of KTs performed in immigrant versus native-born populations in Europe. However, a lesser likelihood for immigrants to receive a pre-emptive kidney transplantation was found. Large heterogeneity between studies (e.g. different sample size, patient origins, study duration, adult vs children patients) was a shortcoming to our analysis. Nevertheless, our article is the first review in this understudied topic. As important questions (e.g. on ethnicity, living donor rate) remain, future studies are needed to address them.</p></div>","PeriodicalId":48973,"journal":{"name":"Transplantation Reviews","volume":"38 1","pages":"Article 100814"},"PeriodicalIF":4.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0955470X2300068X/pdfft?md5=480447307e98f7b28aa184e54aa1c365&pid=1-s2.0-S0955470X2300068X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138515738","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":"Graft retrieval incisions in minimally invasive donor nephrectomy: Systematic review and network meta-analysis","authors":"Khi Yung Fong ,&nbsp;Joshua Chek Hao Foo ,&nbsp;Yiong Huak Chan ,&nbsp;Edwin Jonathan Aslim ,&nbsp;Lay Guat Ng ,&nbsp;Valerie Huei Li Gan ,&nbsp;Ee Jean Lim","doi":"10.1016/j.trre.2023.100813","DOIUrl":"10.1016/j.trre.2023.100813","url":null,"abstract":"<div><h3>Background</h3><p>Various incisions<span> are employed for graft extraction during minimally invasive donor nephrectomy, but an overarching synthesis of associated short-term donor outcomes is lacking.</span></p></div><div><h3>Methods</h3><p><span>An electronic literature search was conducted on PubMed, EMBASE and Scopus for studies comparing ≥2 graft extraction incisions in laparoscopic or robotic donor nephrectomy with ≥10 patients per arm. Eligible study designs included randomized trials, case-control, and cohort studies. Primary outcomes were donor length of stay (LOS); in-hospital </span>analgesic<span> requirement; and postoperative complications<span>. Secondary outcomes were warm ischemia time (WIT), total operation time (TOT), and estimated blood loss (EBL). Random-effects Frequentist network meta-analyses were conducted for all outcomes.</span></span></p></div><div><h3>Results</h3><p>Twenty-nine studies (4702 patients) were shortlisted. Six incisions were analyzed: iliac, Pfannenstiel, midline hand-assisted laparoscopic (HAL), midline umbilical, flank and transvaginal natural orifice transluminal endoscopic surgery<span> (NOTES). The flank incision had significantly longer LOS than all other incisions. LOS was significantly longer in Pfannenstiel than iliac incision (mean difference [MD] = 0.29, 95%CI = 0.002–0.58 days). Midline HAL had significantly shorter TOT than most other incisions. Midline umbilical incisions had significantly higher WIT than midline HAL and Pfannenstiel incisions. Midline HAL had shorter WIT than transvaginal NOTES (MD = 0.80, 95%CI = 0.05–1.56 min). No major differences were seen in analgesia requirement, postoperative complications and EBL.</span></p></div><div><h3>Conclusion</h3><p>Six different incisions for graft retrieval are broadly comparable across most short-term outcomes although long-term outcomes remain to be elucidated. Iliac and Pfannenstiel incisions yielded similar outcomes besides marginally lower LOS for the former. Midline incision for HAL may be associated with shorter TOT, and transvaginal NOTES is an effective technique for selected female donors.</p><p><strong>Trial registration</strong>: PROSPERO CRD42023445407</p></div>","PeriodicalId":48973,"journal":{"name":"Transplantation Reviews","volume":"38 1","pages":"Article 100813"},"PeriodicalIF":4.0,"publicationDate":"2023-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135764153","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":"Non-tuberculous mycobacteria disease pre-lung transplantation: A systematic review of the treatment regimens and duration pre- and post-transplant.","authors":"Johanna P. van Gemert ,&nbsp;Sofanne J. Ravensbergen ,&nbsp;Erik A.M. Verschuuren ,&nbsp;Huib A.M. Kerstjens ,&nbsp;Brigitte W.M. Willemse ,&nbsp;Jakko van Ingen ,&nbsp;Wouter Hoefsloot ,&nbsp;Tji Gan ,&nbsp;Onno W. Akkerman","doi":"10.1016/j.trre.2023.100800","DOIUrl":"10.1016/j.trre.2023.100800","url":null,"abstract":"<div><h3>Background</h3><p>There is lack of consensus on non-tuberculous mycobacteria pulmonary disease (NTM-PD) treatment regimen and duration in patient listed for lung transplantation (LTx). We conducted a systematic review on treatment regimen and duration pre- and directly post-LTx, for patients with known NTM-PD pre-LTx. Additionally, we searched for risk factors for NTM disease development post-LTx and for mortality.</p></div><div><h3>Methods</h3><p>Literature was reviewed on PubMed, Embase and the Cochrane Library, for articles published from inception to January 2022. Individual patient data were sought.</p></div><div><h3>Results</h3><p>Sixteen studies were included reporting 92 patients. Most frequent used agents were aminoglycosides and macrolides for <em>Mycobacterium abscessus</em> (<em>M. abscessus</em>) and macrolides and tuberculostatic agents for <em>Mycobacterium avium</em> complex (<em>M. avium</em> complex). The median treatment duration pre-LTx was 10 months (IQR 6–17) and 2 months (IQR 2–8) directly post-LTx. Longer treatment duration pre-LTx was observed in children and in patients with <em>M. abscessus</em>. 46% of the patients with NTM-PD pre-LTx developed NTM disease post-LTx, related mortality rate was 10%. Longer treatment duration pre-LTx (<em>p</em> &lt; 0.001) and sputum non-conversion pre-LTx (<em>p</em> = 0.003) were significantly associated with development of NTM-disease post-LTx. Longer treatment duration pre-LTx (<em>p</em> = 0.004), younger age (<em>p</em> &lt; 0.001) and sputum non-conversion (<em>p</em> = 0.044) were risk factors for NTM related death.</p></div><div><h3>Conclusions</h3><p>The median treatment duration pre-LTx was 10 months (IQR 6–17) and 2 months (IQR 2–8) directly post-LTx. Patients with longer treatment duration for NTM-PD pre-LTx and with sputum non-conversion are at risk for NTM disease post-LTx and for NTM-related death. Children were particularly at risk for NTM related death.</p></div>","PeriodicalId":48973,"journal":{"name":"Transplantation Reviews","volume":"37 4","pages":"Article 100800"},"PeriodicalIF":4.0,"publicationDate":"2023-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41224585","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":"Management of an aneurysmal arteriovenous fistula in kidney transplant recipients","authors":"Michael Corr ,&nbsp;Kateřina Lawrie ,&nbsp;Peter Baláž ,&nbsp;Stephen O'Neill","doi":"10.1016/j.trre.2023.100799","DOIUrl":"10.1016/j.trre.2023.100799","url":null,"abstract":"<div><p>Aneurysms remain the most common complication of an arteriovenous fistula created for dialysis access. The management of an aneurysmal arteriovenous fistula (AAVF) in kidney transplant recipients remains contentious with a lack of clear clinical guidelines. Recipients of a functioning graft do not require the fistula for dialysis access, however risk of graft failure and needing the access at a future date must be considered. In this review we outline the current evidence in the assessment and management of a transplant recipient with an AAVF. We will describe our recommended five-step approach to assessing an AAVF in transplant patients; 1.) Define AAVF 2.) Risk assess AAVF 3.) Assess transplant graft function and future graft failure risk 4.) Consider future renal replacement therapy options 5.) Vascular mapping to assess future vascular access options. Then we will describe the current therapeutic options and when they would most appropriately be employed.</p></div>","PeriodicalId":48973,"journal":{"name":"Transplantation Reviews","volume":"37 4","pages":"Article 100799"},"PeriodicalIF":4.0,"publicationDate":"2023-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41161596","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":"What are the benefits of preemptive versus non-preemptive kidney transplantation? A systematic review and meta-analysis","authors":"Reshma Rana Magar ,&nbsp;Simon R. Knight ,&nbsp;Umberto Maggiore ,&nbsp;Jeffrey A. Lafranca ,&nbsp;Frank J.M.F. Dor ,&nbsp;Liset H.M. Pengel","doi":"10.1016/j.trre.2023.100798","DOIUrl":"10.1016/j.trre.2023.100798","url":null,"abstract":"<div><p>Opting for a preemptive kidney transplant (PKT) can help avoid costs and morbidity associated with dialysis. However, while multiple studies have shown clinical benefits of PKT, other studies have not demonstrated this, leading to controversy in the literature regarding the exact benefits of PKT. Therefore, this study aimed to determine the clinical outcomes of PKT versus non-preemptive kidney transplantation (nPKT) in adult patients. Multiple databases were searched up to May 4, 2022. Independent reviewers selected studies for inclusion and extracted relevant data. Risk of bias was assessed using the Downs and Black checklist. Eighty-seven studies including 859,715 adult kidney transplant patients were included the review. The risk of patient death (relative risk [95% confidence interval] 0.74 [0.60–0.91]) was significantly lower in PKT versus nPKT patients for living donor (LD) transplants, whereas the risk of overall graft loss was significantly lower in PKT compared to nPKT patients for both LD (0.72 [0.62–0.83]) as well as deceased donor (DD) transplants (0.80 [0.69–0.92]). The evidence suggests that LD PKT patients have a lower risk of patient death and graft loss compared to nPKT patients, and DD PKT patients have a lower risk of graft loss than nPKT patients.</p></div>","PeriodicalId":48973,"journal":{"name":"Transplantation Reviews","volume":"37 4","pages":"Article 100798"},"PeriodicalIF":4.0,"publicationDate":"2023-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41167141","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":"Preoperative fibrinogen level and blood transfusions in liver transplantation: A systematic review","authors":"Félix Thibeault ,&nbsp;Guillaume Plourde ,&nbsp;Massine Fellouah ,&nbsp;Daniela Ziegler ,&nbsp;François Martin Carrier","doi":"10.1016/j.trre.2023.100797","DOIUrl":"10.1016/j.trre.2023.100797","url":null,"abstract":"<div><h3>Background</h3><p><span>Orthotopic liver transplantation (OLT) is a major surgery often associated with significant bleeding. We conducted a </span>systematic review<span><span> to explore the association between preoperative fibrinogen level and intraoperative blood products transfusion, blood loss and clinical outcomes </span>in patients undergoing OLT.</span></p></div><div><h3>Methods</h3><p>We included observational studies conducted in patients undergoing an OLT mostly for end-stage liver disease that reported an association between the preoperative fibrinogen level and our outcomes of interest. Our primary outcome was the intraoperative red blood cell (RBC) transfusion requirements. Our secondary outcomes were intraoperative blood loss, intraoperative transfusion of any blood product, postoperative RBC transfusion, postoperative thrombotic or hemorrhagic complications, and mortality. We used a standardized search strategy. We reported our results mostly descriptively but conducted meta-analyses using random-effect models when judged feasible.</p></div><div><h3>Results</h3><p><span>We selected 24 cohort studies reporting at least one of our outcomes. We found that a high preoperative fibrinogen level was associated with fewer intraoperative RBC and other blood products transfusions, and lower blood loss. We also found a lower overall survival in patients with a higher fibrinogen level (pooled hazard ratio [95% CI] of 1.50 [1.23 to 1.84]; 5 studies, </span><em>n</em> = 1012, I² = 48%). Only one study formally explored a fibrinogen level threshold effect. Overall, reporting was heterogeneous, and risk of bias was variable mostly because of uncontrolled confounding.</p></div><div><h3>Conclusion</h3><p>A higher preoperative fibrinogen level was associated with fewer intraoperative RBC and other blood products transfusions, lower blood loss, and higher mortality. Further studies may help clarify observed associations and inform guidelines.</p></div>","PeriodicalId":48973,"journal":{"name":"Transplantation Reviews","volume":"37 4","pages":"Article 100797"},"PeriodicalIF":4.0,"publicationDate":"2023-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41164043","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":"The use of lymphocyte-depleting antibodies in specific populations of kidney transplant recipients: A systematic review and meta-analysis","authors":"Nuria Montero ,&nbsp;Emilio Rodrigo ,&nbsp;Marta Crespo ,&nbsp;Josep M. Cruzado ,&nbsp;Alex Gutierrez-Dalmau ,&nbsp;Auxiliadora Mazuecos ,&nbsp;Asunción Sancho ,&nbsp;Lara Belmar ,&nbsp;Emma Calatayud ,&nbsp;Paula Mora ,&nbsp;Laia Oliveras ,&nbsp;Eulalia Solà ,&nbsp;Florentino Villanego ,&nbsp;Julio Pascual","doi":"10.1016/j.trre.2023.100795","DOIUrl":"10.1016/j.trre.2023.100795","url":null,"abstract":"<div><h3>Background</h3><p>Recommendations of the use of antibody induction treatments in kidney transplant recipients (KTR) are based on moderate quality and historical studies. This systematic review aims to reevaluate, based on actual studies, the effects of different antibody preparations when used in specific KTR subgroups.</p></div><div><h3>Methods</h3><p>We searched MEDLINE and CENTRAL and selected randomized controlled trials (RCT) and observational studies looking at different antibody preparations used as induction in KTR. Comparisons were categorized into different KTR subgroups: standard, high risk of rejection, high risk of delayed graft function (DGF), living donor, and elderly KTR. Two authors independently assessed the risk of bias.</p></div><div><h3>Results</h3><p>Thirty-seven RCT and 99 observational studies were finally included. Compared to anti-interleukin-2-receptor antibodies (IL2RA), anti-thymocyte globulin (ATG) reduced the risk of acute rejection at two years in standard KTR (RR 0.74, 95%CI 0.61–0.89) and high risk of rejection KTR (RR 0.55, 95%CI 0.43–0.72), but without decreasing the risk of graft loss. We did not find significant differences comparing ATG vs. alemtuzumab or different ATG dosages in any KTR group.</p></div><div><h3>Conclusions</h3><p>Despite many studies carried out on induction treatment in KTR, their heterogeneity and short follow-up preclude definitive conclusions to determine the optimal induction therapy. Compared with IL2RA, ATG reduced rejection in standard-risk, highly sensitized, and living donor graft recipients, but not in high DGF risk or elderly recipients. More studies are needed to demonstrate beneficial effects in other KTR subgroups and overall patient and graft survival.</p></div>","PeriodicalId":48973,"journal":{"name":"Transplantation Reviews","volume":"37 4","pages":"Article 100795"},"PeriodicalIF":4.0,"publicationDate":"2023-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41173869","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":"The British Transplantation Society guidelines on cardiothoracic organ transplantation from deceased donors after circulatory death","authors":"Vasudev Pai ,&nbsp;Ellie Asgari ,&nbsp;Marius Berman ,&nbsp;Chris Callaghan ,&nbsp;Paul Corris ,&nbsp;Stephen Large ,&nbsp;Simon Messer ,&nbsp;David Nasralla ,&nbsp;Jas Parmar ,&nbsp;Chris Watson ,&nbsp;Stephen O'Neill","doi":"10.1016/j.trre.2023.100794","DOIUrl":"10.1016/j.trre.2023.100794","url":null,"abstract":"<div><p>Maximising organ utilisation from donation after circulatory death (DCD) donors could help meet some of the shortfall in organ supply, but it represents a major challenge, particularly as organ donors and transplant recipients become older and more medically complex over time. Success is dependent upon establishing common practices and accepted protocols that allow the safe sharing of DCD organs and maximise the use of the DCD donor pool. The British Transplantation Society ‘Guideline on transplantation from deceased donors after circulatory death’ has recently been updated. This manuscript summarises the relevant recommendations from chapters specifically related to transplantation of cardiothoracic organs.</p></div>","PeriodicalId":48973,"journal":{"name":"Transplantation Reviews","volume":"37 4","pages":"Article 100794"},"PeriodicalIF":4.0,"publicationDate":"2023-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10201580","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":"Efficacy of denosumab on bone metabolism and bone mineral density in renal transplant recipients: A systematic review and meta-analysis","authors":"Peiqin Zhu ,&nbsp;Tong Yang ,&nbsp;Jun Le ,&nbsp;Xiaoting Fu ,&nbsp;Liang Zhang","doi":"10.1016/j.trre.2023.100793","DOIUrl":"10.1016/j.trre.2023.100793","url":null,"abstract":"<div><h3>Background</h3><p><span>Post-transplant bone disease (PTBD) is a common complication in kidney transplant recipients. This </span>systematic review<span> and meta-analysis evaluates the efficiency and safety of denosumab<span> for the treatment of PTBD in kidney transplant recipients.</span></span></p></div><div><h3>Methods</h3><p>Comprehensive search of PubMed Central, SCOPUS, EMBASE, MEDLINE, Cochrane trial registry, Google Scholar, and <span>Clinicaltrials.gov</span><svg><path></path></svg><span> databases was done for studies, published until April 2023. Primary outcomes included changes in bone mineral density (BMD) and T-scores. Secondary outcomes included incidence of fractures, alterations in bone turnover markers, and the incidence of adverse events.</span></p></div><div><h3>Results</h3><p>Eleven studies with a total of 511 participants that underwent kidney transplant were included. Denosumab treatment resulted in a significant improvement in lumbar spine<span> BMD (SMD: -0.31, 95% CI: −0.56 to −0.06) and T-score (SMD: -1.07, 95% CI: −1.51 to −0.64), while no differences were detected in hip/femoral neck BMD and the T-score. There was no marked change in the fracture incidence (OR: 0.42, 95% CI: 0.06 to 3.07). However, patients who received denosumab treatment had an increased incidence rate of hypocalcemia (OR: 9.98, 95% CI: 1.72 to 57.88).</span></p></div><div><h3>Conclusions</h3><p><span>Denosumab treatment may improve lumbar spine BMD and T-scores in patients with PTBD. However, it does not significantly affect fracture incidence and may increase the risk of hypocalcemia. These findings underline the necessity for well-powered, </span>randomized controlled trials to further clarify the role of denosumab in managing PTBD.</p></div>","PeriodicalId":48973,"journal":{"name":"Transplantation Reviews","volume":"37 4","pages":"Article 100793"},"PeriodicalIF":4.0,"publicationDate":"2023-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10139977","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}