BACKGROUND: The use of aspirin in chronic kidney disease patients has been shown to reduce myocardial infarction but may increase major bleeding. However, its effects in kidney transplant recipients are unclear.

METHODS:A literature search was performed using MEDLINE, EMBASE, and Cochrane Database of Systematic Reviews from inception through September 2016. We included studies that reported odd ratios, relative risks or hazard ratios comparing outcomes of aspirin use in kidney transplant recipients. Pooled risk ratios (RR) and 95% confidence interval (CI) were assessed using a random-effect, generic inverse variance method.

RESULTS: We included 9 studies; enrolling 19,759 kidney transplant recipients that compared aspirin with no treatment. Compared to no treatment, aspirin reduced the risk of allograft failure (4 studies; RR 0.57, 95% CI 0.33 to 0.99), allograft thrombosis (2 studies; RR 0.11, 95% CI 0.02 to 0.53), and major adverse cardiac events or mortality (2 studies; RR 0.72, 95% CI 0.59 to 0.88), but not allograft rejection (3 studies; RR 0.86, 95% CI 0.45 to 1.65) or delayed graft function (2 studies; RR 1.00, 95% CI 0.58 to 1.72) in kidney transplant recipients. The data on risk of major or minor bleeding were limited. CONCLUSION: Our meta-analysis demonstrates reduced risks of allograft failure, allograft thrombosis, and major adverse cardiac events or mortality, but not allograft rejection or delayed graft function. Future studies are needed to assess the risk of bleeding, and ultimately weigh the overall risks and benefits of aspirin use in specific kidney transplant patient populations.

CITATION INFORMATION: Cheungpasitporn W, Thongprayoon C, Mitema D, Mao M, Kittanamongkolchai W, Gonzalez-Suarez M, Erickson S. The Effects of Aspirin on Major Adverse Cardiac Events and Kidney Allograft Outcomes: A Meta-Analysis. Am J Transplant. 2017;17 (suppl 3).

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