Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA.
Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA.
Transpl Int. 2021 Nov;34(11):2071-2086. doi: 10.1111/tri.14016. Epub 2021 Sep 23.
Post-transplant erythrocytosis (PTE) can occur in up to 10-16% after kidney transplant (KT). However, the post-transplant outcomes of recipients with PTE in the literature were conflicting. We performed systematic review and meta-analysis of published studies to evaluate risk factors of PTE as well as outcomes of recipients who developed PTE compared with controls. A literature search was conducted evaluating all literature from existence through February 2, 2021, using MEDLINE and EMBASE. Data from each study were combined using the random-effects model. (PROSPERO: CRD42021230377). Thirty-nine studies from July 1982 to January 2021 were included (7,099 KT recipients). The following factors were associated with PTE development: male gender (pooled RR = 1.62 [1.38, 1.91], I = 39%), deceased-donor KT (pooled RR = 1.18 [1.03, 1.35], I = 32%), history of smoking (pooled RR = 1.36 [1.11, 1.67], I = 13%), underlying polycystic kidney disease (PKD) (pooled RR=1.56 [1.21, 2.01], I =44%), and pretransplant dialysis (pooled RR=1.6 [1.02, 2.51], I =46%). However, PTE was not associated with outcomes of interest, including overall mortality, death-censored graft failure, and thromboembolism. Our meta-analysis demonstrates that male gender, deceased-donor KT, history of smoking, underlying PKD, and pretransplant dialysis were significantly associated with developing PTE. However, with proper management, PTE has no impact on prognosis of KT patients.
肾移植后红细胞增多症（PTE）在肾移植（KT）后发生率可达 10-16%。然而，文献中 PTE 患者的移植后结局结果相互矛盾。我们对已发表的研究进行了系统评价和荟萃分析，以评估 PTE 的危险因素以及与对照组相比发生 PTE 的受者的结局。通过 MEDLINE 和 EMBASE 对从存在到 2021 年 2 月 2 日的所有文献进行了文献检索。使用随机效应模型合并每项研究的数据。（PROSPERO：CRD42021230377）。纳入 1982 年 7 月至 2021 年 1 月的 39 项研究（7099 例 KT 受者）。以下因素与 PTE 发生相关：男性（汇总 RR=1.62 [1.38, 1.91]，I =39%）、尸肾移植（汇总 RR=1.18 [1.03, 1.35]，I =32%）、吸烟史（汇总 RR=1.36 [1.11, 1.67]，I =13%）、潜在多囊肾病（PKD）（汇总 RR=1.56 [1.21, 2.01]，I =44%）和移植前透析（汇总 RR=1.6 [1.02, 2.51]，I =46%）。然而，PTE 与感兴趣的结局无关，包括总体死亡率、受死亡影响的移植物失败和血栓栓塞。我们的荟萃分析表明，男性、尸肾移植、吸烟史、潜在的 PKD 和移植前透析与 PTE 的发生显著相关。然而，通过适当的管理，PTE 对 KT 患者的预后没有影响。
