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Comparison of Sirolimus Combined With Tacrolimus and Mycophenolate Mofetil Combined With Tacrolimus in Kidney Transplantation Recipients: A Meta-Analysis
Authors:L. Gao  F. Xu  H. Cheng  J. Liu
Affiliation:1. Department of Gynecology, Zhejiang Provincial People''s Hospital, People''s Hospital of Hangzhou Medical College, Hangzhou, China;2. Department of Gynecology, The Affiliated Hospital of Hangzhou Normal University, Hangzhou, China;3. Department of Urology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China;4. People''s Hospital of Hangzhou Medical College, Hangzhou, China
Abstract:

Purpose

The study was designed to compare the outcomes of sirolimus (SRL) combined with tacrolimus (TAC) and mycophenolate mofetil (MMF) combined with TAC in kidney transplantation recipients.

Methods

A literature search of PubMed, Embase, and Web of Science was performed to identify relevant studies, and the last update was on February 1, 2018. All studies with appropriate data comparing the SRL group with the MMF group were included. SRL and MMF were used in sufficient doses. Relevant information was recorded and analyzed. Odds ratios (ORs) with corresponding 95% confidence intervals (CIs) were used to assess the effects of SRL and MMF. Relevant outcomes, including delayed graft function, acute rejection, graft survival, seroma, anemia, lymphocele, and hyperlipidemia, were compared.

Results

Ten studies with a total of 2357 patients (n = 1256 receiving SRL vs n = 1101 receiving MMF) were ultimately included. Our results indicated that the SRL group experienced a higher rate of hyperlipidemia (OR: 1.864; 95% CI, 1.494–2.325) and lymphocele (OR: 2.58; 95% CI, 1.49–4.47). However, no significant differences were detected regarding the rates of delayed graft function, acute rejection, graft survival, infectious complications, anemia, or seroma.

Conclusions

This meta-analysis suggested that SRL combined with TAC and MMF combined with TAC were equally safe and effective for the kidney transplantation recipients. However, the MMF group exhibited a marginally significant advantage of lower incidence of hyperlipidemia and lymphocele.
Keywords:Address correspondence to Jinwei Liu, People's Hospital of Hangzhou Medical College, No. 158 Shangtang Road, Xiacheng District, 310000 Hangzhou, China. Tel: +86 0571 85893339   Fax: 010-84832676-808.
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