Impact of immunosuppression on incidence of post-transplant diabetes mellitus in solid organ transplant recipients: Systematic review and meta-analysis.

Sreelakshmi Kotha, Bishoy Lawendy, Saira Asim, Charlene Gomes, Jeffrey Yu, Ani Orchanian-Cheff, George Tomlinson, Mamatha Bhat
{"title":"Impact of immunosuppression on incidence of post-transplant diabetes mellitus in solid organ transplant recipients: Systematic review and meta-analysis.","authors":"Sreelakshmi Kotha,&nbsp;Bishoy Lawendy,&nbsp;Saira Asim,&nbsp;Charlene Gomes,&nbsp;Jeffrey Yu,&nbsp;Ani Orchanian-Cheff,&nbsp;George Tomlinson,&nbsp;Mamatha Bhat","doi":"10.5500/wjt.v11.i10.432","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Solid organ transplantation is a life-saving intervention for end-stage organ disease. Post-transplant diabetes mellitus (PTDM) is a common complication in solid organ transplant recipients, and significantly compromises long-term survival beyond a year.</p><p><strong>Aim: </strong>To perform a systematic review and meta-analysis to estimate incidence of PTDM and compare the effects of the 3 major immunosuppressants on incidence of PTDM.</p><p><strong>Methods: </strong>Two hundred and six eligible studies identified 75595 patients on Tacrolimus, 51242 on Cyclosporine and 3020 on Sirolimus. Random effects meta-analyses was used to calculate incidence.</p><p><strong>Results: </strong>Network meta-analysis estimated the overall risk of developing PTDM was higher with tacrolimus (OR = 1.4 95%CI: 1.0-2.0) and sirolimus (OR = 1.8; 95%CI: 1.5-2.2) than with Cyclosporine. The overall incidence of PTDM at years 2-3 was 17% for kidney, 19% for liver and 22% for heart. The risk factors for PTDM most frequently identified in the primary studies were age, body mass index, hepatitis C, and African American descent.</p><p><strong>Conclusion: </strong>Tacrolimus tends to exhibit higher diabetogenicity in the short-term (2-3 years post-transplant), whereas sirolimus exhibits higher diabetogenicity in the long-term (5-10 years post-transplant). This study will aid clinicians in recognition of risk factors for PTDM and encourage careful evaluation of the risk/benefit of different immunosuppressant regimens in transplant recipients.</p>","PeriodicalId":68893,"journal":{"name":"世界移植杂志(英文版)","volume":"11 10","pages":"432-442"},"PeriodicalIF":0.0000,"publicationDate":"2021-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/20/9c/WJT-11-432.PMC8529944.pdf","citationCount":"13","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"世界移植杂志(英文版)","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.5500/wjt.v11.i10.432","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 13

Abstract

Background: Solid organ transplantation is a life-saving intervention for end-stage organ disease. Post-transplant diabetes mellitus (PTDM) is a common complication in solid organ transplant recipients, and significantly compromises long-term survival beyond a year.

Aim: To perform a systematic review and meta-analysis to estimate incidence of PTDM and compare the effects of the 3 major immunosuppressants on incidence of PTDM.

Methods: Two hundred and six eligible studies identified 75595 patients on Tacrolimus, 51242 on Cyclosporine and 3020 on Sirolimus. Random effects meta-analyses was used to calculate incidence.

Results: Network meta-analysis estimated the overall risk of developing PTDM was higher with tacrolimus (OR = 1.4 95%CI: 1.0-2.0) and sirolimus (OR = 1.8; 95%CI: 1.5-2.2) than with Cyclosporine. The overall incidence of PTDM at years 2-3 was 17% for kidney, 19% for liver and 22% for heart. The risk factors for PTDM most frequently identified in the primary studies were age, body mass index, hepatitis C, and African American descent.

Conclusion: Tacrolimus tends to exhibit higher diabetogenicity in the short-term (2-3 years post-transplant), whereas sirolimus exhibits higher diabetogenicity in the long-term (5-10 years post-transplant). This study will aid clinicians in recognition of risk factors for PTDM and encourage careful evaluation of the risk/benefit of different immunosuppressant regimens in transplant recipients.

Abstract Image

Abstract Image

Abstract Image

查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
免疫抑制对实体器官移植受者移植后糖尿病发病率的影响:系统回顾和荟萃分析。
背景:实体器官移植是挽救终末期器官疾病生命的干预措施。移植后糖尿病(PTDM)是实体器官移植受者的常见并发症,严重影响一年以上的长期生存。目的:通过系统回顾和荟萃分析来估计PTDM的发病率,并比较3种主要免疫抑制剂对PTDM发病率的影响。方法:226项符合条件的研究,确定75595例他克莫司患者,51242例环孢素患者和3020例西罗莫司患者。随机效应荟萃分析用于计算发病率。结果:网络荟萃分析估计他克莫司(OR = 1.4 95%CI: 1.0-2.0)和西罗莫司(OR = 1.8;95%CI: 1.5-2.2)。2-3年PTDM的总发生率为肾脏17%,肝脏19%,心脏22%。在最初的研究中,PTDM最常见的危险因素是年龄、体重指数、丙型肝炎和非裔美国人血统。结论:他克莫司在短期(移植后2-3年)具有较高的致糖尿病性,而西罗莫司在长期(移植后5-10年)具有较高的致糖尿病性。这项研究将帮助临床医生认识到PTDM的危险因素,并鼓励对移植受者不同免疫抑制方案的风险/收益进行仔细评估。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 去求助
来源期刊
自引率
0.00%
发文量
364
期刊最新文献
Cardiac evaluation of renal transplant candidates with heart failure. Clinical use of donor-derived cell-free DNA in kidney transplantation. Ethical frontiers in liver transplantation. Evolution of liver transplantation in the metabolic dysfunction-associated steatotic liver disease era: Tracking impact through time. Imaging-based prediction of hepatocellular carcinoma recurrence after microwave ablation as bridge therapy: A glimpse into the future.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1