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Effect of Remote Ischemic Conditioning on Organ Transplantation: A Meta-Analysis of Randomized Controlled Trials

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机构: [1]Yunnan Canc Hosp, Dept Surg Stomach & Small Intestine, Kunming 650118, Yunnan, Peoples R China [2]Yunnan Canc Hosp, Dept Anesthesiol, Kunming, Yunnan, Peoples R China [3]Southern Cent Hosp Yunnan Prov, First Peoples Hosp Honghe State, Kunming, Yunnan, Peoples R China [4]Kunming Med Univ, Dept Grad, Kunming, Yunnan, Peoples R China [5]Kunming Maternal & Child Hlth Ctr, Dept Pediat, Kunming, Yunnan, Peoples R China
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Background. Remote ischemic conditioning (RIC) has shown great advantages in protecting organs from ischemia-reperfusion loss and applied research on RIC continues to increase. We performed a systematic review and meta-analysis to comprehensively investigate the value of RIC for different organ transplantation. Methods. We searched PubMed, EMBASE, and the Cochrane Library from inception to November 1, 2023, for randomized controlled trials investigating whether RIC has an advantage in organ transplantation (including heart, lung, liver, and kidney) compared with controls. The primary outcomes varied according to the transplanted organ, including liver transplantation (graft loss, early allograft dysfunction, acute kidney injury, days in hospital, and mortality); kidney transplantation (delayed graft function, acute rejection (AR), graft loss, 50% decrease in serum creatinine, glomerular filtration rate, days in hospital, and mortality); heart and lung transplantation (AR, mortality). Two investigators independently selected suitable trials, assessed trial quality, and extracted the data. Results. A total of 11 randomized controlled trials were included in this study, including six kidney transplants, three liver transplants, and one heart and lung transplant each, with 561 RIC cases and 564 controls, and a total of 1125 patients. The results showed that RIC did not reduce mortality in transplant patients compared with controls (liver transplant: RR0.9, 95% confidence interval [0.31-2.66]; kidney transplant: RR 0.76, 95% confidence interval [0.17-3.33]), graft failure rate (liver transplantation: RR 0.3, 95% confidence interval [0.07, 1.19]; kidney transplantation: RR 0.89, 95% confidence interval [0.35, 2.27]), length of hospital stay (liver transplantation: standard mean difference [SMD] 0.14, 95% confidence interval [-0.15, 0.42]; kidney transplantation: SMD -0.1, 95% confidence interval [-0.3, 0.11]). In addition, RIC did not improve early liver function after liver transplantation (RR 0.97, 95% confidence interval [0.55,1.7]), acute kidney injury after liver transplantation (RR 1.17 95% confidence interval [0.9, 1.54]), delayed functional recovery after renal transplantation (RR 0.84, 95% confidence interval [0.62, 1.15]), AR rate (RR 1.04, 95% confidence interval [0.72, 1.49]), 50% serum creatinine decline rate (RR 1.1, 95% confidence interval [0.88, 1.37]), glomerular filtration rate 3 months after surgery (SMD 0.13, 95% confidence interval [-0.05, 0.31]) and postoperative 12 months glomerular filtration rate (SMD 0.13, 95% confidence interval [-0.06, 0.31]). Conclusion. Remote ischemic modulation does not improve clinical outcomes in patients undergoing organ transplantation (heart, lung, liver, and kidney).

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大类 | 4 区 医学
小类 | 4 区 免疫学 4 区 外科 4 区 移植
最新[2025]版:
大类 | 4 区 医学
小类 | 4 区 免疫学 4 区 外科 4 区 移植
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出版当年[2023]版:
Q4 IMMUNOLOGY Q4 SURGERY Q4 TRANSPLANTATION
最新[2023]版:
Q4 IMMUNOLOGY Q4 SURGERY Q4 TRANSPLANTATION

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第一作者机构: [1]Yunnan Canc Hosp, Dept Surg Stomach & Small Intestine, Kunming 650118, Yunnan, Peoples R China
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