Seroprevalence and risk factors for infection in solid organ transplant patients: A global systematic review and meta-analysis.

This study aimed to assess the global seroprevalence of IgG and IgM antibodies against () in solid organ transplant (SOT) recipients (kidney, liver, heart) through a literature review of studies published until October 24, 2024. Selected studies reported data on anti- IgG and IgM seroprevalence in the post-transplant stage of SOT recipients. A random-effects model estimated pooled seroprevalence rates, and heterogeneity was evaluated using the I statistic. Sensitivity analysis examined prevalence changes after excluding studies, while subgroup analysis of IgG seroprevalence accounted for publication years, countries, continents, WHO regions, sample sizes, and types of transplanted organs. Out of 26 articles and 29 datasets analyzed, 21 articles and 24 datasets involving 19,391 transplant recipients and 880 controls were used to assess anti- IgG and IgM seroprevalence and odds ratios (ORs). Additionally, 8 articles reported the anti- IgG serostatus of donors and recipients. The pooled IgG seropositivity for in SOT recipients was 9.8 % (95 % CI, 4.7-19.4 %), showing significant variation by region and organ type. The anti- IgM seroprevalence in SOT recipients was 6.4 % (95 % CI, 3.3-12 %). Renal transplant recipients exhibited higher IgG seroprevalence compared to liver and heart transplant recipients. The pooled OR for infections in SOT recipients vs. controls was 1.39 (95 % CI, 0.95-2.04,  = 0.08). The highest pooled anti- IgG serostatus was 50.7 % in the undetermined group, followed by 38 % in the D-/R- group, 15.4 % in the D-/R+ group, 10.6 % in the D+/R- group, and 9.9 % in the D+/R+ group. Overall, active infections and its increased risk trend in SOT recipients should not be overlooked.