Affiliation:
1. Department of Nephrology Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College Huazhong University of Science and Technology Wuhan China
2. Department of Hematology and Oncology Children's Hospital of Soochow University Suzhou China
Abstract
AbstractBackground and objectivePneumocystis jirovecii pneumonia (PJP), an opportunistic infection, often leads to an increase in hospitalization time and mortality rates in kidney transplant (KT) recipients. However, the risk factors associated with PJP in KT recipients remain debatable. Therefore, we conducted this meta‐analysis to identify risk factors for PJP, which could potentially help to reduce PJP incidence and improve outcome of KT recipients.MethodsWe systematically retrieved relevant studies in PubMed, EMBASE, and the Cochrane Library up to November 2023. Pooled odds ratios (ORs) or mean differences (MDs) and the corresponding 95% confidence intervals (CIs) were calculated to assess the impact of potential risk factors on the occurrence of PJP.Results27 studies including 42383 KT recipients were included. In this meta‐analysis, age at transplantation (MD = 3.48; 95% CI = .56–6.41; p = .02), cytomegalovirus (CMV) infection (OR = 4.00; 95% CI = 2.53–6.32; p = .001), BK viremia (OR = 3.38; 95% CI = 1.70–6.71; p = .001), acute rejection (OR = 3.66; 95% CI = 2.44–5.49; p = .001), ABO‐incompatibility (OR = 2.51; 95% CI = 1.57–4.01; p = .001), estimated glomerular filtration rate (eGFR) (MD = ‐14.52; 95% CI = ‐25.37– (‐3.67); p = .009), lymphocyte count (MD = ‐.54; 95% CI = ‐.92– (‐.16); p = .006) and anti‐PJP prophylaxis (OR = .53; 95% CI = .28–.98; p = .04) were significantly associated with PJP occurrence.ConclusionOur findings suggest that transplantation age greater than 50 years old, CMV infection, BK viremia, acute rejection, ABO‐incompatibility, decreased eGFR and lymphopenia were risk factors for PJP.