Risk Factors of Invasive Fungal Infection in Recipients After Liver Transplantation: A Systematic Review and Meta-Analysis

肝移植受者侵袭性真菌感染的危险因素:系统评价和荟萃分析

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Abstract

Objectives: Invasive fungal infection (IFI) remains an important cause of mortality in liver transplantation (LT). The objective of this meta-analysis was to identify the risk factors for IFI after LT. Methods: We searched for relevant studies published up to June 2020 from PubMed, Web of Science, Embase, and the Cochrane Library. Odds ratios (ORs) and their corresponding 95% CIs were used to identify significant differences in the risk factors. Heterogeneity between studies was evaluated by the I (2) test, and potential publication bias was assessed with Egger's test. The quality of included studies was evaluated with the Newcastle-Ottawa Scale (NOS). Results: A total of 14 studies enrolling 4,284 recipients were included in the meta-analysis. Reoperation (OR = 2.18, 95% CI: 1.61-2.94), posttransplantation dialysis (OR = 2.03, 95% CI: 1.52-2.72), bacterial infection (OR = 1.81, 95% CI: 1.33-2.46), live donor (OR = 1.78, 95% CI: 1.20-2.63), retransplantation (OR = 2.45, 95% CI: 1.54-3.89), and fungal colonization (OR = 2.60, 95% CI: 1.99-3.42) were associated with the risk factors of IFI after LT. Conclusions: Despite some risk factors that have been identified as significant factors for IFI post-LT, which may inform prevention recommendations, rigorous and well-designed studies with adequate sample sizes should be conducted to solve the limitations of this study.

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