Pneumocystis Pneumonia Following Solid Organ Transplantation, Systematic Review and Meta-Analysis.
1Medicine, Western University, London, ON, Canada
2Epidemiology and Biostatistics, Western University, London, ON, Canada.
Meeting: 2016 American Transplant Congress
Abstract number: D97
Keywords: Fungal infection, Immunosuppression, Infection, Pneumonia
Session Information
Date: Tuesday, June 14, 2016
Session Name: Poster Session D: Fungi, PJP, Mycobacteria, Infection Risk Factors, Vaccination and Donor Derived Infections
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Halls C&D
Background: Different variables have been reported that may increase the risk of pneumocystis pneumonia (PCP) in solid organ transplant patients (SOT).
Objectives:To investigate the effect of induction therapy, immunosuppression, post-transplant events, and comorbid conditions on PCP in SOTs.
Search methods:
We searched Medline, EMBASE, Web of Science, Cochrane , Dissertation and the World Health Organization (Oct 05,2015). All studies reported probable risk factors of PCP in adult SOTs were included. We excluded case reports, pediatric patients (age <18 years), HIV positive patients and hematopoetic stem cell transplants. Initially, we collected 802 publications. After duplication removal, 654 publications remained for three levels of screening including title, abstract and full-text assessments. Finally, 58 papers remained for final assessment. We identified 65 variables as probable risk factors. We carried out meta analysis on the variables that were reported as risk factors of PCP by at least 3 studies. Other variables that were not included in meta analysis will be separately presented.
Results:
Cytomegalovirus (CMV) increases the risk of PCP (pooled OR:3.83, CI95%: 2.28 to 6.43), 
. Organ rejection is another risk factor of PCP (pooled OR: 2.8, CI95%: 1.8-4.4), 
. Immunosuppressive medications including calcineurins inhibitors, mycophenolate mofetil, methylprednisolone thymoglobulin, basiliximab non-significantly increase the risk of PCP after SOT.
Conclusion:To our knowledge, this is the first systematic review and meta analysis considering risk factor in PCP after SOT. Allograft rejection and CMV infection significantly increase the risk of PCP in SOTs. Further studies are required to determine the effectiveness of prophylactic strategies against PCP in SOTs with these two risk factors.
CITATION INFORMATION: Hosseini-Moghaddam S, Krishnan R. Pneumocystis Pneumonia Following Solid Organ Transplantation, Systematic Review and Meta-Analysis. Am J Transplant. 2016;16 (suppl 3).
To cite this abstract in AMA style:
Hosseini-Moghaddam S, Krishnan R. Pneumocystis Pneumonia Following Solid Organ Transplantation, Systematic Review and Meta-Analysis. [abstract]. Am J Transplant. 2016; 16 (suppl 3). https://atcmeetingabstracts.com/abstract/pneumocystis-pneumonia-following-solid-organ-transplantation-systematic-review-and-meta-analysis/. Accessed March 6, 2021.« Back to 2016 American Transplant Congress