Cytomegalovirus infection and graft rejection as risk factors for pneumocystis pneumonia in solid organ transplant recipients: A systematic review and meta‐analysis |
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| Authors: | Seyed M. Hosseini‐Moghaddam Rohin Jayaram Krishnan Hui Guo Deepali Kumar |
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| Affiliation: | 1. MultiOrgan Transplant Program, Division of Infectious Diseases, Department of Medicine, London Health Sciences Centre, Western University, London, Ontario, Canada;2. The Department of Epidemiology& Biostatistics, Western University, London, Ontario, Canada;3. Multiorgan Transplant Program, Toronto General Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada |
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| Abstract: | A growing number of publications have reported the outbreaks of post‐transplant pneumocystis pneumonia (PJP). In most studies, the onset of PJP was beyond 6‐12 months of prophylaxis. Cytomegalovirus (CMV) infection and allograft rejection have been repeatedly reported as probable risk factors for post‐transplant PJP. In this systematic review and meta‐analysis, we determined the pooled effect estimates of these 2 variables as risk factors. Data sources included PUBMED, MEDLINE‐OVID, EMBASE‐OVID, Cochrane Library, Networked Digital Library of Theses and Dissertations, World Health Organization, and Web of Science. We excluded publications related to hematopoietic stem cell transplantation (HSCT) or Human Immunodeficiency Virus (HIV) patients. Eventually, 15 studies remained for the final stage of screening. Cytomegalovirus infection (OR: 3.30, CI 95%: 2.07‐5.26, I2: 57%, P = 0.006) and allograft rejection (OR:2.36, CI95%: 1.54‐3.62, I2: 45.5%, P = 0.05) significantly increased the risk of post‐transplant PJP. Extended prophylaxis targeting recipients with allograft rejection or CMV infection may reduce the risk of PJP. |
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| Keywords: |
PCP
Pneumocystis jirovecii
pneumocystis pneumonia solid organ transplantation systematic review |
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