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

作　　者：Sreelakshmi Kotha Bishoy Lawendy Saira Asim Charlene Gomes Jeffrey Yu Ani Orchanian-Cheff George Tomlinson Mamatha Bhat 

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

出　　处：《World Journal of Transplantation》2021年第10期432-442,共11页世界移植杂志

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 

分 类 号：R58[医药卫生—内分泌]