Department of Pharmacy and Therapeutics, University of Pittsburgh, Pittsburgh, PA, USA.
Department of Thoracic Medicine, St. Vincent's Hospital, Sydney, NSW, Australia.
Clin Transplant. 2018 May;32(5):e13235. doi: 10.1111/ctr.13235. Epub 2018 Mar 30.
A systematic review of papers in English on post-transplant lymphoproliferative disorder (PTLD) in lung transplant recipients (LTR) using MEDLINE, EMBASE, SCOPUS, and Cochrane databases was performed. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations were strictly adhered to. Pooled odds ratios (pOR) were calculated from a random-effects model, and heterogeneity among studies was quantitated using I values. Fourteen studies published from 2005 to 2015 were included in the meta-analysis. One hundred and sixty-four lung transplant recipients were included. LTRs who received single vs bilateral were associated with a 7.67-fold risk of death after PTLD (6 studies with 64 LTRs; pOR 7.67 95% CI 1.98-29.70; P = .003). pOR of death for early onset PTLD (<1 year post-LT) vs late onset (>1 year post-LT) was not different (3 studies with 72 LTRS; pOR 0.62, 95% CI 0.20-1.86, P = .39). Standardized mean difference (SMD) in time from transplant to PTLD onset between LTRs who died vs alive was not different (9 studies with 109 LTRs; SMD 0.03, 95% CI -0.48-0.53, P = .92). Survival in polymorphic vs monomorphic PTLD and extranodal vs nodal disease was similar (4 studies with 31 LTRs; pOR 0.44, 95% CI 0.08-2.51; P = .36. 6 studies with 81 LTRs; pOR 1.05 95% CI 0.31-3.52, P = .94). This meta-analysis demonstrates that single LTRs are at a higher risk of death vs bilateral LTRs after the development of PTLD.
对在肺移植受者（LTR）中发生的移植后淋巴组织增生性疾病（PTLD）的英文文献进行了系统评价，使用的数据库有 MEDLINE、EMBASE、SCOPUS 和 Cochrane 数据库。严格遵循系统评价和荟萃分析的首选报告项目（PRISMA）建议。使用随机效应模型计算汇总优势比（pOR），并使用 I 值量化研究之间的异质性。荟萃分析纳入了 2005 年至 2015 年发表的 14 项研究。共纳入 164 例肺移植受者。与双侧肺移植相比，单侧肺移植后发生 PTLD 的死亡风险增加了 7.67 倍（6 项研究，64 例 LTR；pOR 7.67，95%CI 1.98-29.70；P=0.003）。早期（LT 后 1 年内）与晚期（LT 后 1 年以上）PTLD 患者的死亡风险 pOR 无差异（3 项研究，72 例 LTR；pOR 0.62，95%CI 0.20-1.86，P=0.39）。死亡的 LTR 与存活的 LTR 之间从移植到 PTLD 发病的时间标准化均数差（SMD）无差异（9 项研究，109 例 LTR；SMD 0.03，95%CI -0.48-0.53，P=0.92）。多形性与单形性 PTLD 以及结外与结内疾病的生存率相似（4 项研究，31 例 LTR；pOR 0.44，95%CI 0.08-2.51；P=0.36；6 项研究，81 例 LTR；pOR 1.05，95%CI 0.31-3.52，P=0.94）。本荟萃分析表明，单侧 LTR 发生 PTLD 后死亡的风险高于双侧 LTR。
