Outcomes of kidney transplantation in patients with hepatitis B virus infection:A systematic review and meta-analysis

• 作者: Ankit Sakhuja Charat Thongprayoon Franco H Cabeza Rivera Karn Wijarnpreecha Konika Sharma Napat Leeaphorn Patompong Ungprasert Wisit Cheungpasitporn Wisit Kaewput
• 来源期刊: 世界肝病学杂志：英文版（电子版）
• 学科: 医学
• 关键词: Hepatitis B KIDNEY TRANSPLANT KIDNEY RENAL TRANSPLANTATION TRANSPLANTATION META-ANALYSIS
• 年，卷（期）: 2018,（2）
• 页码范围: 337-346
• 页数: 10页
• 分类号: R

摘要

AIM To assess outcomes of kidney transplantation including patient and allograft outcomes in recipients with hepatitis B virus(HBV)infection,and the trends of patient’s outcomes overtime.METHODS A literature search was conducted using MEDLINE,EMBASE and Cochrane Database from inception through October 2017.Studies that reported odds ratios(OR)of mortality or renal allograft failure after kidney transplantation in patients with HBV[defined as hepatitis B surface antigen(HBsAg)positive]were included.The comparison group consisted of HBsAgnegative kidney transplant recipients.Effect estimates from the individual study were extracted and combined using random-effect,generic inverse variance method of DerSimonian and Laird.The protocol for this metaanalysis is registered with PROSPERO(International Prospective Register of Systematic Reviews;no.CRD42017080657).RESULTS Ten observational studies with a total of 87623 kidney transplant patients were enrolled.Compared to HBsAg-negative recipients,HBsAg-positive status was significantly associated with increased risk of mortality after kidney transplantation(pooled OR=2.48;95%CI:1.61-3.83).Meta-regression showed significant negative correlations between mortality risk after kidney transplantation in HBsAg-positive recipients and year of study(slopes=-0.062,P=0.001).HBsAgpositive status was also associated with increased risk of renal allograft failure with pooled OR of 1.46(95%CI:1.08-1.96).There was also a significant negative correlation between year of study and risk of allograft failure(slopes=-0.018,P=0.002).These associations existed in overall analysis as well as in limited cohort of hepatitis C virus-negative patients.We found no publication bias as assessed by the funnel plots and Egger’s regression asymmetry test with P=0.18 and 0.13 for the risks of mortality and allograft failure after kidney transplantation in HBsAg-positive recipients,respectively.CONCLUSION Among kidney transplant patients,there are significant associations between HBsAg-positive status a