移植中的亚临床排斥和移植存活率:系统审查和元分析的协议
Arjun Lalit Kalaria1, Takayuki Yamada2, Michele Klein-Fedyshin3
1Division of Transplant Nephrology, Thomas E Starzl Transplantation Institute, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA a_kalaria@yahoo.com.
BMJ open
|July 18, 2024
概括
移植中的亚临床排斥 (SCR) 可能会影响长期的移植存活率. 这一系统性审查将分析研究,以澄清SCR对代移植损失和未来拒绝事件的影响.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 移植免疫学 移植免疫学
- 临床研究方法论临床研究方法论
背景情况:
- 亚临床排斥 (SCR) 被定义为没有代移植功能障碍的急性排斥.
- SCR对脏移植结果的长期影响尚未得到充分证实.
- 澄清SCR的影响对于优化移植后管理至关重要.
研究的目的:
- 系统地审查和综合关于亚临床排斥对长期移植异位移植存活率的影响的证据.
- 调查SCR与随后排斥事件的发展之间的联系.
- 提供SCR在移植结果中的作用的全面分析.
主要方法:
- 在MEDLINE,Embase和Cochrane Central (1995-2023) 的系统文献搜索.
- 包括成人移植接受者的英语研究,不包括"因果"活检.
- 使用随机效应模型进行元分析,评估偏差和异质性风险.
主要成果:
- 主要结局:死亡审查的全移植损失.
- 二次结果:后续排斥的发展.
- 危险比率和风险比率将优先进行分析.
结论:
- 这一系统性审查将阐明移植中亚临床拒绝的预后意义.
- 研究结果将为临床实践提供有关移植接受者的监测和管理的信息.
- 综合证据将解决关于SCR对移植存活的影响的持续辩论.
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