PuSH - Publication Server of Helmholtz Zentrum München

Oliveras, L.* ; Coloma, A.* ; Lloberas, N.* ; Lino, L.* ; Fava, A.* ; Manonelles, A.* ; Codina, S.* ; Couceiro, C.* ; Melilli, E.* ; Sharif, A.* ; Hecking, M.* ; Guthoff, M. ; Cruzado, J.M.* ; Pascual, J.* ; Montero, N.*

Immunosuppressive drug combinations after kidney transplantation and post-transplant diabetes: A systematic review and meta-analysis.

Transplant. Rev. 38:100856 (2024)
DOI PMC
Open Access Green as soon as Postprint is submitted to ZB.
Post-transplant diabetes mellitus (PTDM) is a frequent complication after kidney transplantation (KT). This systematic review investigated the effect of different immunosuppressive regimens on the risk of PTDM. We performed a systematic literature search in MEDLINE and CENTRAL for randomized controlled trials (RCTs) that included KT recipients with any immunosuppression and reported PTDM outcomes up to 1 October 2023. The analysis included 125 RCTs. We found no differences in PTDM risk within induction therapies. In de novo KT, there was an increased risk of developing PTDM with tacrolimus versus cyclosporin (RR 1.71, 95%CI [1.38-2.11]). No differences were observed between tacrolimus+mammalian target of rapamycin inhibitor (mTORi) and tacrolimus+MMF/MPA, but there was a tendency towards a higher risk of PTDM in the cyclosporin+mTORi group (RR 1.42, 95%CI [0.99-2.04]). Conversion from cyclosporin to an mTORi increased PTDM risk (RR 1.89, 95%CI [1.18-3.03]). De novo belatacept compared with a calcineurin inhibitor resulted in 50% lower risk of PTDM (RR 0.50, 95%CI [0.32-0.79]). Steroid avoidance resulted in 31% lower PTDM risk (RR 0.69, 95%CI [0.57-0.83]), whereas steroid withdrawal resulted in no differences. Immunosuppression should be decided on an individual basis, carefully weighing the risk of future PTDM and rejection.
Altmetric
Additional Metrics?
[➜Log in]
Edit extra informations Login
Publication type Article: Journal article
Document type Scientific Article
Keywords Immunosuppression ; Kidney Transplant ; Meta-analysis ; Post-transplant Diabetes; Trial Comparing Tacrolimus; Chronic Allograft Nephropathy; Prospective Randomized-trial; Early Steroid Withdrawal; Plus Mycophenolate-mofetil; Calcineurin-inhibitor; Long-term; Renal-transplantation; Phase-iii; Early Conversion
ISSN (print) / ISBN 0955-470X
e-ISSN 1557-9816
Journal Transplantation Reviews
Quellenangaben Volume: 38, Issue: 3, Pages: , Article Number: 100856 Supplement: ,
Publisher Elsevier
Publishing Place Ste 800, 230 Park Ave, New York, Ny 10169 Usa
Reviewing status Peer reviewed
Institute(s) Institute of Diabetes Research and Metabolic Diseases (IDM)
Grants Mecanismo para la Recuperacion y la Resiliencia (MRR)
Spanish Government Instituto de Salud Carlos III (ISCIII)