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Effects of omega-3 fatty acids on organ transplantation

Bibliographic details: Bonis P, Chung M, Tatsioni A, Sun Y, Kupelnick B, Lichtenstien A, Perrone R, Chew P, DeVine D, Lau J.  Effects of omega-3 fatty acids on organ transplantation. Rockville, MD, USA: Agency for Healthcare Research and Quality. Evidence Report/Technology Assessment; 115. 200515810864

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2005

Safety and efficacy of cyclosporine A trough level monitoring and 2 hours level post-administration monitoring in organ transplantation recipients: a meta analysis.

Bibliographic details: Li HJ, Ping WW.  Safety and efficacy of cyclosporine A trough level monitoring and 2 hours level post-administration monitoring in organ transplantation recipients: a meta analysis. Journal of Clinical Rehabilitative Tissue Engineering Research 2011; 15(31): 5756-5760 Available from: http://www.crter.org/Html/2011_08_30/2025_10505_2011_08_30_165346.html

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2011

Do CD4+Foxp3+ Treg cells correlate with transplant outcomes: A systematic review on recipients of solid organ transplantation.

Regulatory T cells (Tregs) are considered to be critical for the induction of transplant tolerance. Tregs counts were measured in blood, biopsy and urine sample after transplantation in many studies. Although not unanimous, some studies have suggested that Tregs is associated with better outcome and can also serve as an immune marker to predict the individual risk of rejection and identify tolerant patients. In this study, we systematically reviewed the correlation between Tregs and transplant outcomes, identifying if Tregs can predict transplant rejection and tolerance. A total of 22 articles were included and assessed, the results showed that Tregs in recipients are helpful to maintain a stable graft function, reduce acute/chronic rejection rate. And the Tregs in graft and urine, rather than in PBL, may have a better diagnostic value for transplant outcomes. However, since the low quality of included studies, results may be influenced by bias. More high quality studies with bigger sample size are still needed in future.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2011

Prevention and treatment of glucocorticoid-induced osteoporosis with active vitamin D3 analogues: a review with meta-analysis of randomized controlled trials including organ transplantation studies

The aim of this review with meta-analysis was to determine if there is a rationale to use activated forms of vitamin D3 to treat or prevent glucocorticoid-induced osteoporosis, and to compare the effect of active vitamin D3 metabolites with that of other anti-osteoporosis therapies. We performed a systemic search using MEDLINE/PubMed (1966-2003). Animal studies and clinical trials involving humans with data on therapy to treat or prevent glucocorticoid-induced osteoporosis with active vitamin D3 analogues were included. Animal studies and basic research studies with active vitamin D3 were reviewed (qualitative review). Meta-analysis (quantitative review) on clinical trials (including organ transplantation studies) was performed with percent change in lumbar spine bone mineral density or bone mineral content as the primary outcome measure; the secondary outcome measure was incidence of vertebral fractures. Fifty-four articles were found. Animal and basic research studies showed that active vitamin D3 analogues can inhibit bone loss during treatment with glucocorticoids. Concerning the effect on bone mineral density, the pooled effect size of active vitamin D3 analogues compared with no treatment, placebo, plain vitamin D3 and/or calcium was 0.35 (95% confidence interval (CI) 0.18, 0.52). Compared with bisphosphonates, the pooled effect size was -1.03 (95% CI -1.71, -0.36). The pooled estimate of the relative risk for vertebral fractures of active vitamin D3 analogues compared with no treatment, placebo, plain vitamin D3 and/or calcium was 0.56 (95% CI 0.34, 0.92) and compared with bisphosphonates it was 1.20 (95% CI 0.32, 4.55). Active vitamin D3 analogues not only preserve bone during glucocorticoid therapy more effectively than no treatment, placebo, plain vitamin D3 and/or calcium, but are also more effective in decreasing the risk of vertebral fractures. Bisphosphonates, however, are more effective in preserving bone and decreasing the risk of vertebral fractures than active vitamin D3 analogues.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2004

Clinical pharmacy services and solid organ transplantation: a literature review

The review concluded that although high quality evidence showing benefit was rare, evidence existed regarding the positive impact that clinical pharmacy services had on several as aspects of the care of solid organ transplant patients. Flaws in the review methodology and reporting suggested the authors' over-optimistic conclusions should be interpreted with much caution.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2010

Role of chemotherapy and rituximab for treatment of posttransplant lymphoproliferative disorder in solid organ transplantation

This review concluded, from limited evidence, that overall response rates for rituximab and/or chemotherapy for post-transplant lymphoproliferative disorder treatment after solid organ transplantation ranged from 50 to 100% and five-year survival was 60%. The authors’ cautious conclusions appear to reflect the limited quantity and quality of the data, but their reliability is difficult to assess due to poor reporting.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2007

Prevention of fractures after solid organ transplantation: a meta-analysis

This review concluded that treatment with bisphosphonates or active vitamin D analogues during the first year after solid organ transplantation was associated with a reduction in bone fractures. The authors' conclusions reflect the review results, but it should be noted that there were only two trials of vitamin D analogues included and data were not reported separately for these trials.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2011

Kidney and liver organ transplantation in persons with human immunodeficiency virus: an evidence-based analysis

OBJECTIVE: The objective of this analysis is to determine the effectiveness of solid organ transplantation in persons with end stage organ failure (ESOF) and human immunodeficiency virus (HIV+)

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2010

Solid organ transplantation: technical progress meets human dignity – a review of the literature considering elderly patients' health related quality of life following transplantation

INTRODUCTION: Many transplant studies in elderly patients focus on survival and mortality rates. It was the aim of this review to evaluate publications dealing with individual patient performance and independence.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2012

The efficacy and safety of alemtuzumab and daclizumab versus antithymocyte globulin during organ transplantation: a meta-analysis

OBJECTIVE: The objective of this study was to compare efficacy and safety of alemtuzumab, antithymocyte globulin (ATG), and daclizumab for induction therapy in organ transplantation.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2012

Natriuretic peptides in the management of solid organ transplantation associated acute kidney injury: a systematic review and meta-analysis

Randomized controlled trials involving natriuretic peptide administration in solid organ transplantation setting have shown inconsistent effects for renal endpoints. We conducted a systematic review and meta-analysis of these trials to ascertain the role of natriuretic peptides in the management of solid organ transplantation associated acute kidney injury (AKI). MEDLINE, EMBASE, and Google scholar were searched independently by two authors for randomized trials evaluating renal effects of natriuretic peptides in solid organ transplantation settings. Two reviewers independently assessed the studies for eligibility and extracted the relevant data. The pooled estimate showed that natriuretic peptide administration is associated with a reduction in AKI requiring dialysis (odds ratio = 0.50 [0.26-0.97]), a statistically nonsignificant trend toward improvement in posttransplant creatinine clearance (weighted mean difference = 5.5 mL/min, [-1.3 to 12.2 mL/min]), and reduction in renal replacement requirement duration (weighted mean difference -44.0 hours, [-60.5 to -27.5 hours]). There were no mortality events and no adverse events related to natriuretic peptides. In conclusion, administration of natriuretic peptides in solid organ transplantation may be associated with significant improvements in renal outcomes. These observations need to be confirmed in an adequately powered, prospective multicenter study.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2013

Serologic vaccination response after solid organ transplantation: a systematic review

BACKGROUND: Infectious diseases after solid organ transplantation (SOT) are one of the major complications in transplantation medicine. Vaccination-based prevention is desirable, but data on the response to active vaccination after SOT are conflicting.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2013

MRSA and VRE colonization in solid organ transplantation: a meta-analysis of published studies

The burden of methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococcus (VRE) colonization among the increasing number of solid organ transplant patients has not been systematically explored. We searched PubMed and EMBASE for pertinent articles, performed a meta-analysis of prevalence across eligible studies and estimated the risk of ensuing MRSA or VRE infections relative to colonization status. We stratified effects in the pretransplant and posttransplant period. Twenty-three studies were considered eligible. Seventeen out of 23 (74%) referred to liver transplants. Before transplantation, the pooled prevalence estimate for MRSA and VRE was 8.5% (95% confidence interval [CI] 3.2–15.8) and 11.9% (95% CI 6.8–18.2), respectively. MRSA estimate was influenced by small studies and was lower (4.0%; 95% CI 0.4–10.2) across large studies (>200 patients). After transplantation, the prevalence estimates were 9.4% (95% CI 3.0–18.5) for MRSA and 16.2% (95% CI 10.7–22.6) for VRE. Pretransplant as well as posttransplant MRSA colonization significantly increased the risk for MRSA infections (pooled risk ratio [RR] 5.51; 95% CI 2.36–12.90 and RR 10.56; 95% CI 5.58–19.95, respectively). Pretransplant and posttransplant VRE colonization were also associated with significant risk of VRE infection (RR 6.65; 95% CI 2.54–17.41 and RR 7.93; 95% CI 2.36–26.67, respectively). Solid organ transplantation is a high-risk setting for MRSA and VRE colonization, and carrier state is associated with infection. Upgraded focus in prevention and eradication strategies is warranted.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2014

Risk of serious opportunistic infections after solid organ transplantation: interleukin-2 receptor antagonists versus polyclonal antibodies. A meta-analysis

BACKGROUND: We aimed to evaluate and quantify the risk of serious opportunistic infections after induction with polyclonal antibodies versus IL-2 receptor antagonists (IL-2RAs) in randomized clinical trials.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2014

Contraceptive use among solid organ transplant patients: a systematic review

BACKGROUND: Women undergoing solid organ transplantation are advised to avoid pregnancy for up to 24 months following transplant surgery.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2010

A systematic review of the adverse effects of tacrolimus in organ transplant patients

The authors stated that no firm conclusion on the efficacy of tacrolimus to prevent graft rejection in organ transplantation could be made due to variation across studies. Despite weaknesses in the review process, given the variation between the studies the authors' cautious conclusions reflect the evidence presented and appear appropriate.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2011

Utility of monitoring mycophenolic acid in solid organ transplant patients

This review assessed the impact of mycophenolic acid (MPA) monitoring on health outcomes including rejection and adverse events in solid organ transplant patients. The authors concluded that there is almost no evidence to suggest that MPA monitoring affects these outcomes. This was a well-conducted review and the conclusion is likely to be reliable.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2008

CMV-hyperimmune globulin for preventing cytomegalovirus infection and disease in solid organ transplant recipients: a meta-analysis

This review, which assessed the effectiveness of cytomegalovirus hyperimmune globulin in preventing cytomegalovirus disease in organ transplant recipients, concluded that cytomegalovirus hyperimmune globulin improved total survival, reduced cytomegalovirus disease, and reduced cytomegalovirus-associated deaths. A lack of reporting of certain data means that the authors' conclusions should be interpreted with some caution.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2008

Do wound complications or lymphoceles occur more often in solid organ transplant recipients on mTOR inhibitors? A systematic review of randomized controlled trials

This review found that immediate use of mammalian target of rapamycin (mTOR) inhibitors lead to a higher incidence of wound complications and lymphoceles in solid organ transplant patients, and should be avoided in the first few months after transplantation. There was some potential for bias in the review, but the authors' conclusions reflect the evidence and seem reliable.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2011

Valganciclovir for cytomegalovirus prevention in solid organ transplant patients: an evidence-based reassessment of safety and efficacy

The authors concluded that valganciclovir was not the preferred first-line agent for the prevention of cytomegalovirus disease (pre-emptive/universal prophylaxis) in solid organ transplant patients. While aspects of this review were well conducted and the conclusions appeared to reflect the results, the quality of some of the included studies was unknown, making it difficult to assess the reliability of the findings.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2009

Medical Encyclopedia

  • Lung Transplant
    A lung transplant is surgery to remove a person’s diseased lung and replace it with a healthy lung from a deceased donor.
  • Heart Transplant
    A heart transplant is surgery to remove a person's diseased heart and replace it with a healthy heart from a deceased donor.
  • Bronchiectasis
    Bronchiectasis is a condition in which damage to the airways causes them to widen and become flabby and scarred.
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Systematic Reviews in PubMed

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