Interventions to Improve Life Participation in Kidney Transplant Recipients: A Systematic Review

Area of Science:

• Nephrology
• Transplantation Medicine
• Rehabilitation Science

Background:

• Life participation, crucial for kidney transplant recipients' quality of life, involves engaging in meaningful daily activities.
• Evaluating interventions to enhance life participation is essential for post-transplant care.
• Current evidence on interventions impacting life participation in this population is limited.

Purpose of the Study:

• To systematically review randomized controlled trials evaluating interventions for life participation in kidney transplant recipients.
• To assess the effectiveness of various interventions on improving meaningful daily activities post-transplantation.

Main Methods:

• A systematic review of randomized controlled studies was conducted.
• Searches were performed in MEDLINE, Embase, CENTRAL, PsycINFO, and CINAHL up to March 2023.
• Data extraction and risk of bias assessment were performed independently by two authors.

Main Results:

• Out of 14,162 reports, 33 studies with 4,857 participants were included.
• No studies specifically reported 'life participation' as an outcome.
• Mental, physical, and social functioning were reported in 15%, 15%, and 33% of studies, respectively, with high or unclear risk of bias in most domains.

Conclusions:

• Evidence for interventions like prebiotics, ESAs, immunosuppressants, exercise, nutrition, education, and surgery on life participation-related outcomes remains uncertain.
• There is a significant lack of research specifically measuring life participation in kidney transplant recipients.
• Further high-quality trials are urgently needed to identify effective interventions for improving life participation in kidney transplant recipients.