دورية أكاديمية
Calcineurin Inhibition in Deceased Organ Donors: A Systematic Review and Meta-analysis of Preclinical Studies
| العنوان: | Calcineurin Inhibition in Deceased Organ Donors: A Systematic Review and Meta-analysis of Preclinical Studies |
|---|---|
| المؤلفون: | Frédérick D’Aragon, MD, William Rousseau, MD, Ruth Breau, BA, Daniel Aminaei, BSc, Carole Ichai, MD, Gordon J. Boyd, MD, PhD, Karen E. A. Burns, MD, Héloïse Cardinal, MD, PhD, François-Martin Carrier, MD, Michaël Chassé, MD, PhD, Prosanto Chaudhury, MD, Sonny Dhanani, MD, Shane W. English, MD, Anne Julie Frenette, PhD, Steven Hanna, PhD, Gregory Knoll, MD, François Lauzier, MD, Simon Oczkowski, MD, Bram Rochwerg, MD, Khaled Shamseddin, MD, Marat Slessarev, MD, PhD, Darin Treleaven, MD, Alexis F. Turgeon, MD, Matthew J. Weiss, MD, Markus Selzner, MD, Maureen O. Meade, MD |
| المصدر: | Transplantation Direct, Vol 9, Iss 9, p e1519 (2023) |
| بيانات النشر: | Wolters Kluwer, 2023. |
| سنة النشر: | 2023 |
| المجموعة: | LCC:Surgery |
| مصطلحات موضوعية: | Surgery, RD1-811 |
| الوصف: | Background. Preconditioning deceased organ donors with calcineurin inhibitors (CNIs) may reduce ischemia–reperfusion injury to improve transplant outcomes. Methods. We searched MEDLINE, EMBASE, Cochrane Library, and conference proceedings for animal models of organ donation and transplantation, comparing donor treatment with CNIs with either placebo or no intervention, and evaluating outcomes for organ transplantation. Reviewers independently screened and selected studies, abstracted data, and assessed the risk of bias and clinical relevance of included studies. Where possible, we pooled results using meta-analysis; otherwise, we summarized findings descriptively. Results. Eighteen studies used various animals and a range of CNI agents and doses and evaluated their effects on a variety of transplant outcomes. The risk of bias and clinical applicability were poorly reported. Pooled analyses suggested benefit of CNI treatment on early graft function in renal transplants (3 studies; serum creatinine: ratio of means [RoM] 0.54; 95% confidence interval [CI], 0.34-0.86) but not for liver transplants (2 studies; serum alanine transaminase: RoM 0.61; 95% CI, 0.30-1.26; and serum aspartate aminotransferase: RoM 0.58; 95% CI, 0.26-1.31). We found no reduction in graft loss at 7 d (2 studies; risk ratio 0.54; 95% CI, 0.08-3.42). CNI treatment was associated with reduced transplant recipient levels of interleukin-6 (4 studies; RoM 0.36; 95% CI, 0.19-0.70), tumor necrosis factor-alpha (5 studies; RoM 0.36; 95% CI, 0.12-1.03), and cellular apoptosis (4 studies; RoM 0.30; 95% CI, 0.19-0.47). Conclusions. Although this compendium of animal experiments suggests that donor preconditioning with CNIs may improve early kidney graft function, the limited ability to reproduce a true clinical environment in animal experiments and to assess for risk of bias in these experiments is a serious weakness that precludes current clinical application. |
| نوع الوثيقة: | article |
| وصف الملف: | electronic resource |
| اللغة: | English |
| تدمد: | 2373-8731 00000000 |
| العلاقة: | http://journals.lww.com/transplantationdirect/fulltext/10.1097/TXD.0000000000001519Test; https://doaj.org/toc/2373-8731Test |
| DOI: | 10.1097/TXD.0000000000001519 |
| الوصول الحر: | https://doaj.org/article/43a6a8df8ad14bb3b40fe07168d9342eTest |
| رقم الانضمام: | edsdoj.43a6a8df8ad14bb3b40fe07168d9342e |
| قاعدة البيانات: | Directory of Open Access Journals |
Full Text Finder | تدمد: | 23738731 00000000 |
|---|---|
| DOI: | 10.1097/TXD.0000000000001519 |