术前计算机断层扫描诊断肌肉减少症对同种异体移植和肾移植术后预后的预后意义：一项系统回顾和荟萃分析。

IF 0.8 4区医学 Q4 IMMUNOLOGY

Transplantation proceedings Pub Date : 2025-04-29 DOI:10.1016/j.transproceed.2025.03.013

Khang Duy Ricky Le , Steven Nguyen , Samyuktha Gomez , Adnan Hassanali , Hussein Hassanali , Amy Barnett , Rosemary Masterson , Peter Hughes , Karen M. Dwyer

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引用次数: 0

摘要

背景：鉴别从肾移植中获益最多的个体是具有挑战性的，对于哪些临床特征提供了最重要的预后信息还没有明确的共识。最近，计算机断层扫描（CT）诊断的肌肉减少症在预测实体器官移植受者较差的预后方面被证明是准确的。本系统综述和荟萃分析评估了术前CT定义的肌肉减少症在预测肾移植患者术后受体和同种异体移植物预后中的作用。方法：在Medline、Embase、谷歌Scholar和CINAHL数据库中进行综合文献检索。本综述纳入了7篇文章，涉及1153例患者。结果：有强有力的证据表明，ct定义的肌肉减少症与死亡率增加（OR: 2.72, 95% CI, 1.66-4.47, P < 0.0001）和再入院可能性增加（OR: 1.98, 95% CI, 1.34-2.92, P = 0.00006）相关。缺乏证据支持术前CT将肌肉减少症定义为肾移植后同种异体移植和其他术后结果的预后因素。结论：本系统综述和荟萃分析表明，CT成像发现的移植前肌肉减少症可预测死亡率和再入院率的增加。鉴于与偏倚和异质性风险相关的证据的局限性，需要进行更有力的前瞻性研究，以阐明CT诊断的肌肉减少症作为肾移植环境中预后因素的真实作用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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The Prognostic Significance of Preoperative Computed Tomography Diagnosed Sarcopenia on Allograft and Postoperative Outcomes Following Kidney Transplantation: A Systematic Review and Meta-Analysis

Background

The identification of individuals who will benefit most from kidney transplantation is challenging, with no clear consensus as to which clinical features provide the most prognostic information. Recently, computed tomography (CT)-diagnosed sarcopenia has proven to be accurate in predicting poorer outcomes solid organ transplant recipients. This systematic review and meta-analysis evaluates the role of sarcopenia, as defined by preoperative CT, in the prediction of postoperative recipient and allograft outcomes in patients undergoing kidney transplantation.

Methods

A comprehensive literature search was performed on Medline, Embase, Google Scholar and CINAHL databases. Seven articles involving 1153 patients were included in this review.

Results

There was strong evidence to suggest that CT-defined sarcopenia was associated with increased mortality (OR: 2.72, 95% CI, 1.66-4.47, P < .0001) and greater likelihood of readmission (OR: 1.98, 95% CI, 1.34-2.92, P = .00006). There was a lack of evidence to support the use of preoperative CT to define sarcopenia as a prognostic factor for allograft and other postoperative outcomes following kidney transplantation.

Conclusions

This systematic review and meta-analysis demonstrates evidence to suggest pretransplant sarcopenia identified on CT imaging is predictive of increased mortality and readmission. Given the limitations of evidence related to risk of bias and heterogeneity, there is a need for more robust prospective research to elucidate the true effect of CT diagnosed sarcopenia as a prognostic factor in the kidney transplant setting.

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来源期刊

Transplantation proceedings 医学-免疫学

CiteScore

1.70

自引率

0.00%

发文量

502

审稿时长

60 days

期刊介绍： Transplantation Proceedings publishes several different categories of manuscripts, all of which undergo extensive peer review by recognized authorities in the field prior to their acceptance for publication. The first type of manuscripts consists of sets of papers providing an in-depth expression of the current state of the art in various rapidly developing components of world transplantation biology and medicine. These manuscripts emanate from congresses of the affiliated transplantation societies, from Symposia sponsored by the Societies, as well as special Conferences and Workshops covering related topics. Transplantation Proceedings also publishes several special sections including publication of Clinical Transplantation Proceedings, being rapid original contributions of preclinical and clinical experiences. These manuscripts undergo review by members of the Editorial Board. Original basic or clinical science articles, clinical trials and case studies can be submitted to the journal?s open access companion title Transplantation Reports.