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

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World Journal of Hepatology 2018年第2期10卷 337-346页

作者： Charat Thongprayoon Wisit Kaewput Konika Sharma Karn Wijarnpreecha Napat Leeaphorn Patompong Ungprasert ankit Sakhuja Franco H Cabeza Rivera Wisit Cheungpasitporn Department of Internal Medicine Bassett Medical CenterCooperstownNY 13326United States Department of Military and Community Medicine Phramongkutklao College of MedicineBangkok 10400Thailand Division of Nephrology Department of MedicineBeth Israel Deaconess Medical CenterBostonMA 02215United States Clinical Epidemiology Unit Department of Research and developmentFaculty of Medicine Siriraj HospitalMahidol UniversityBangkok 10700Thailand Division of Pulmonary and Critical Care Medicine Department of MedicineMayo ClinicRochesterMN 55905United States Division of Nephrology Department of MedicineUniversity of Mississippi Medical CenterJacksonMS 39216United States

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 *** 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(HBs ag) positive] were included. The comparison group consisted of HBs agnegative kidney transplant recipients. Effect estimates from the individual study were extracted and combined using random-effect, generic inverse variance method of Der Simonian 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 HBs ag-negative recipients, HBs ag-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 HBs ag-positive recipients and year of study(slopes =-0.062, P = 0.001). HBs agpositive 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 HBs ag-positive recipients, *** Among kidn

关键词： Hepatitis B Kidney transplant Kidney Renal transplantation Transplantation Meta-analysis

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