Occurrence rate and risk factors for acute kidney injury after lung transplantation: a systematic review and meta-analysis.

Abstract

Background: Compared with other solid organ transplantation, the morbidity rate of acute kidney injury is higher in lung transplantation. Our research was designed to examine the occurrence rate and risk factors for acute kidney injury after lung transplantation through a systematic review and meta-analysis.

Methodology: We conducted a database search for case-control studies and cohort studies on the occurrence rate and risk factors for acute kidney injury after lung transplantation up to August 19, 2023. Stata 15.0 was used for data analysis.

Results: Nineteen case-control or cohort studies were included, involving 1,755 cases of acute kidney injury after lung transplantation and 1,404 cases of non-acute kidney injury after lung transplantation. Based on the meta-analysis, the risk factors for acute kidney injury after lung transplantation included pulmonary fibrosis (OR, 1.34; CI [1.09-1.65]), hypertension (OR, 1.30; CI [1.07-1.58]), pre-op mechanical ventilation (OR, 3.30; CI [1.84-5.90]), pre-op extracorporeal membrane oxygenation (OR, 3.70; CI [2.51-5.45]), double lung transplantation (OR, 1.91; CI [1.45-2.53]), cardiopulmonary bypass support (OR, 1.82; CI [1.38-2.40]), cardiovascular events (OR, 1.50; CI [1.15-1.96]), intra-op hypotension (OR, 2.70; CI [1.42-5.14]), post-op extracorporeal membrane oxygenation (OR, 1.90; CI [1.20-3.01]), sepsis (OR, 3.20; CI [2.16-4.73]), dialysis (OR, 12.79; CI [6.11-26.8]).

Conclusions: Based on the existing evidence, clinical professionals can implement early detection, diagnosis and treatment of patients with acute kidney injury after lung transplantation, to improve the quality of life of these patients.