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

查看全文 作　　者：Sreelakshmi [1]Kotha;Bishoy [2]Lawendy;Saira [3]Asim;Charlene [2]Gomes;Jeffrey [2]Yu;Ani Orchanian-[2]Cheff;George [4]Tomlinson;Mamatha [5]Bhat 高影响力作者 机构地区：[1]Department of Gastroenterology,Guy's and St Thomas'Hospital,London SE17JD,United Kingdom;[2]Department of Multi-Organ Transplantation,Toronto General Hospital,Toronto M5G 2C4,Canada;[3]Multi Organ Transplant Program,Toronto General Hospital,Toronto M5G 2C4,Canada;[4]Dalla Lana School of Public Health,Department of Medicine,University Health Network-Toronto General Hospital,University of Toronto,Toronto M5G 2C4,Canada;[5]Multi-organ Transplant,Toronto General Hospital,Toronto M5G 2C4,Canada高影响力机构 出　　处：《World Journal of Transplantation》索引2021年第11卷第10期,共11页高影响力期刊 摘　　要：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=1.495%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 longterm(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. 关 键 词：Post-transplant diabetes mellitus solid organ transplantation TACROLIMUS CYCLOSPORIN SIROLIMUS
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