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Association Between Solid Organ Transplantation and Oral Candidiasis: A Systematic Review and Meta-Analysis
Neha Shah1, Sangeeta Sinha1, Abhay Sonthalia2
1Department of Oral Pathology, Guru Nanak Institute of Dental Sciences and Research (GNIDSR), Kolkata, West Bengal, India.
Summary
Solid organ transplant recipients have a significantly increased risk of oral candidiasis. This meta-analysis confirms a higher incidence of fungal infections in these immunocompromised patients compared to controls.
Area of Science:
- Immunology
- Infectious Diseases
- Transplantation Medicine
Background:
- Solid organ transplantation requires significant immunosuppression, increasing susceptibility to opportunistic infections.
- Oral candidiasis is a common fungal infection that can affect transplant recipients.
Purpose of the Study:
- To synthesize existing evidence on the association between solid organ transplantation and oral candidiasis.
- To quantify the risk of oral candidiasis in solid organ transplant recipients.
Main Methods:
- Systematic review and meta-analysis of case-control and cohort studies.
- Quality assessment using the Newcastle-Ottawa scale.
- Pooled odds ratios calculated using random-effects or fixed-effects models.
- Certainty of evidence assessed using the GRADE approach.
Main Results:
- A pooled odds ratio of 3.52 (95% CI: 1.92, 6.46) indicates an increased risk of candidiasis in solid organ transplant recipients.
- Specific transplant types showed higher risks: kidney (OR=3.53), liver (OR=20.12), and heart (OR=152.01).
Conclusions:
- Moderate certainty evidence supports an increased risk of oral candidiasis in immunosuppressed solid organ transplant recipients.
- Further research is needed for pancreas and small bowel transplants, and the role of prophylactic antifungals.
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