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Enhanced Recovery after Renal Transplantation Decreases Recipients’ Urological Complications and Hospital Stay: A Systematic Review and Meta-Analysis

The objective of this study was to compare enhanced recovery after surgery (ERAS) against traditional perioperative care for renal transplant recipients. Outcome measures included complications, length of stay (LOS), readmission rates, graft and patient survival up to one-year post-transplant. We in...

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Autores principales: Prionas, Apostolos, Craddock, Charles, Papalois, Vassilios
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8197515/
https://www.ncbi.nlm.nih.gov/pubmed/34070325
http://dx.doi.org/10.3390/jcm10112286
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author Prionas, Apostolos
Craddock, Charles
Papalois, Vassilios
author_facet Prionas, Apostolos
Craddock, Charles
Papalois, Vassilios
author_sort Prionas, Apostolos
collection PubMed
description The objective of this study was to compare enhanced recovery after surgery (ERAS) against traditional perioperative care for renal transplant recipients. Outcome measures included complications, length of stay (LOS), readmission rates, graft and patient survival up to one-year post-transplant. We initially screened Medline, Cochrane, Scopus, Embase and Web of Science databases. We identified 3029 records. From these, 114 full texts were scrutinized for inclusion. Finally, 10 studies were included in the meta-analysis corresponding to 2037 renal transplant recipients. ERAS resulted in lower incidence of urological complications (95CI: 0.276, 0.855) (I(2) = 53.08%) compared to traditional perioperative practice. This referred to ureteric stenoses (95CI: 0.186–0.868) (I(2) = 0%) and urinary tract infections (95CI: 0.230–0.978) (I(2) = 71.55%). ERAS decreased recipients’ LOS (95CI: −2.876, −0.835) (I(2) = 86.55%). Compared to standard practice, ERAS protocols did not increase unplanned readmissions (95CI:0.800, 1.680) (I(2) = 0%). Up to one-year post-transplant, graft survival rates were similar across the ERAS and the control groups (95CI:0.420, 1.722) (I(2) = 0%). There was also no difference in recipients’ one-year post-transplant survival (95CI:0.162, 3.586) (I(2) = 0%). Our results suggest that ERAS protocols can be safely incorporated in the perioperative care of renal transplant recipients, decrease their urological complications and shorten their length of hospital stay without affecting unplanned readmission rates.
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spelling pubmed-81975152021-06-13 Enhanced Recovery after Renal Transplantation Decreases Recipients’ Urological Complications and Hospital Stay: A Systematic Review and Meta-Analysis Prionas, Apostolos Craddock, Charles Papalois, Vassilios J Clin Med Review The objective of this study was to compare enhanced recovery after surgery (ERAS) against traditional perioperative care for renal transplant recipients. Outcome measures included complications, length of stay (LOS), readmission rates, graft and patient survival up to one-year post-transplant. We initially screened Medline, Cochrane, Scopus, Embase and Web of Science databases. We identified 3029 records. From these, 114 full texts were scrutinized for inclusion. Finally, 10 studies were included in the meta-analysis corresponding to 2037 renal transplant recipients. ERAS resulted in lower incidence of urological complications (95CI: 0.276, 0.855) (I(2) = 53.08%) compared to traditional perioperative practice. This referred to ureteric stenoses (95CI: 0.186–0.868) (I(2) = 0%) and urinary tract infections (95CI: 0.230–0.978) (I(2) = 71.55%). ERAS decreased recipients’ LOS (95CI: −2.876, −0.835) (I(2) = 86.55%). Compared to standard practice, ERAS protocols did not increase unplanned readmissions (95CI:0.800, 1.680) (I(2) = 0%). Up to one-year post-transplant, graft survival rates were similar across the ERAS and the control groups (95CI:0.420, 1.722) (I(2) = 0%). There was also no difference in recipients’ one-year post-transplant survival (95CI:0.162, 3.586) (I(2) = 0%). Our results suggest that ERAS protocols can be safely incorporated in the perioperative care of renal transplant recipients, decrease their urological complications and shorten their length of hospital stay without affecting unplanned readmission rates. MDPI 2021-05-25 /pmc/articles/PMC8197515/ /pubmed/34070325 http://dx.doi.org/10.3390/jcm10112286 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Prionas, Apostolos
Craddock, Charles
Papalois, Vassilios
Enhanced Recovery after Renal Transplantation Decreases Recipients’ Urological Complications and Hospital Stay: A Systematic Review and Meta-Analysis
title Enhanced Recovery after Renal Transplantation Decreases Recipients’ Urological Complications and Hospital Stay: A Systematic Review and Meta-Analysis
title_full Enhanced Recovery after Renal Transplantation Decreases Recipients’ Urological Complications and Hospital Stay: A Systematic Review and Meta-Analysis
title_fullStr Enhanced Recovery after Renal Transplantation Decreases Recipients’ Urological Complications and Hospital Stay: A Systematic Review and Meta-Analysis
title_full_unstemmed Enhanced Recovery after Renal Transplantation Decreases Recipients’ Urological Complications and Hospital Stay: A Systematic Review and Meta-Analysis
title_short Enhanced Recovery after Renal Transplantation Decreases Recipients’ Urological Complications and Hospital Stay: A Systematic Review and Meta-Analysis
title_sort enhanced recovery after renal transplantation decreases recipients’ urological complications and hospital stay: a systematic review and meta-analysis
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8197515/
https://www.ncbi.nlm.nih.gov/pubmed/34070325
http://dx.doi.org/10.3390/jcm10112286
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AT papaloisvassilios enhancedrecoveryafterrenaltransplantationdecreasesrecipientsurologicalcomplicationsandhospitalstayasystematicreviewandmetaanalysis