医学
置信区间
内科学
危险系数
荟萃分析
优势比
糖尿病
肝移植
移植
比例危险模型
内分泌学
作者
Ansel Shao Pin Tang,Char Loo Tan,Wen Hui Lim,Cheng Han Ng,Darren Jun Hao Tan,Rebecca Wenling Zeng,Jieling Xiao,Elden Yen Hng Ong,Elina Cho,Charlotte Hui Chung,Wei Shyann Lim,Douglas Chee,Benjamin Nah,Michael T. Tseng,Nicholas Syn,Glenn Kunnath Bonney,Ken Liu,Daniel Q. Huang,Mark Muthiah,Mohammad Shadab Siddiqui,Eunice X. Tan
出处
期刊:Transplantation
[Ovid Technologies (Wolters Kluwer)]
日期:2023-10-30
被引量:1
标识
DOI:10.1097/tp.0000000000004840
摘要
Preliver transplant diabetes mellitus (pre-LT DM) is a common comorbidity in LT recipients associated with poorer post-transplant survival. However, its relationship with other important outcomes, including cardiovascular and renal outcomes, remains unclear. This meta-analysis aims to provide an updated analysis of the impact of pre-LT DM on key post-LT outcomes.A search was conducted in Medline and Embase databases for articles comparing the post-transplant outcomes between patients with and without pre-LT DM. Pairwise analysis using random effects with hazard ratios (HRs) was used to assess the longitudinal post-LT impacts of pre-LT DM. In the absence of HR, pooled odds ratios analysis was conducted for secondary outcomes.Forty-two studies involving 77,615 LT recipients were included in this analysis. The pooled prevalence of pre-LT DM amongst LT recipients was 24.79%. Pre-LT DM was associated with significantly lower overall survival (HR, 0.65; 95% confidence interval, 0.52-0.81; P<0.01) and significantly increased cardiovascular disease-related mortality (HR, 1.78; 95% confidence interval, 1.11-2.85; P=0.03). Meta-regression of other patient characteristics identified Asian ethnicity and hypertension to be significant predictors of worse overall survival, whereas African-American ethnicity was associated with significantly improved overall survival in patients with pre-LT DM. Further analysis of secondary outcomes revealed pre-LT DM to be a significant predictor of post-LT cardiovascular events and end-stage renal disease.The present study illustrates the impact of pre-LT DM on post-LT survival, and cardiovascular and renal outcomes and provides a sound basis for revision of preoperative management of pre-LT DM.
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