荟萃分析
固体器官
器官移植
器官共享联合网络
医学
重症监护医学
梅德林
老年学
内科学
移植
生物
肝移植
生物化学
作者
Donghua Geng,Sheng Wang,Xinyue Wu,Xinhua Hu
标识
DOI:10.1016/j.arr.2024.102364
摘要
There is controversy surrounding the association between preexisting frailty and increased mortality in candidates and recipients of solid-organ transplants. This meta-analysis aimed to evaluate the impact of preexisting frailty on survival outcomes in solid-organ transplant candidates and recipients. A systematic search was conducted in the PubMed, Web of Sciences, and Embase databases until October 2, 2023. Two reviewers independently selected the eligible studies according to the PECOS criteria: Participants (candidates and recipients of solid-organ transplants), Exposure (frailty), Comparison (no-frailty), Outcomes (waitlist or posttransplant mortality), and Study design (retrospective or prospective cohort studies). The pooled effects were summarized by pooling the adjusted hazard ratio (HR) with 95% confidence intervals (CI) for the frail patients than those without frailty. Sixteen studies with 10091 patients met the eligibility criteria. Depending on the frailty tools used, the prevalence of frailty in solid-organ transplant candidates/recipients ranged from 4.6% to 45.1%. Frailty was significantly associated with an increased risk of waitlist mortality (HR 2.44; 95% CI 1.84-3.24) and posttransplant mortality (HR 2.23; 95% CI 1.61-3.09) in solid-organ transplant candidates and recipients, respectively. Subgroup analyses showed that the association of preexisting frailty with waitlist mortality and posttransplant mortality appeared to stronger in kidney transplant candidates (HR 2.70; 95% CI 1.93-3.78) and lung transplantation recipients (HR 2.52; 95% CI 1.23-5.15). Frailty is a significant predictor of reduced survival in solid-organ transplant candidates and recipients. Assessment of frailty has the potential to identify patients who are suitable for transplantation.
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