Effectiveness of immunosuppression minimisation, conversion or withdrawal strategies in paediatric solid organ and haematopoietic stem cell transplantation: A protocol of a systematic review and meta-analysis
Autor (es)
Martin Saborido, Carlos; Borobia Pérez, Alberto M.; Cobas, Javier; D'Antiga, Lorenzo; Frauca, Esteban; Hernández-Oliveros, Francisco; Jara, Paloma; López-Granados, Eduardo; Muñoz, Jose María; Nicastro, Emanuele; Ojeda, Jose Jonay; Pérez Martínez, Antonio; Torres, Juan Manuel; Carcas Sansuán, Antonio JavierEntidad
UAM. Departamento de Farmacología; UAM. Departamento de PediatríaEditor
BMJFecha de edición
2020-12-03Cita
10.1136/bmjopen-2020-037721
BMJ Open 10.12 (2020): e037721
ISSN
2044-6055DOI
10.1136/bmjopen-2020-037721Financiado por
This work was supported by The European Commission and the Consumers, Health, Agriculture and Food Executive Agency (CHAFEA). Grant agreements number: SGA 770411, SGA 811558 and SGA 847103Versión del editor
http://doi.org/10.1136/bmjopen-2020-037721Materias
paediatric cardiology; paediatric gastroenterology; paediatric hepatology; paediatric nephrology; paediatric oncology; paediatric transplant surgery; MedicinaDerechos
© 2020 Author(s) (or their employer(s))Resumen
Introduction Paediatric transplantation is the only curative therapeutic procedure for several end-stage rare diseases affecting different organs and body systems, causing altogether great impact in European children's health and quality of life. Transplanted children shift their primary disease to a chronic condition of immunosuppression to avoid rejection. Longer life expectancy in children poses a greater risk of prolonged and severe side effects related to long-term immunosuppressive (IS) disabilities and secondary cancer susceptibility. The goal remains to find the best combination of IS agents that optimises allograft survival by preventing acute rejection while limiting drug toxicities. This systematic review will aim to determine the optimal IS strategy within the so-called minimisation, conversion or withdrawal strategies. Methods and analysis We will search the following databases with no language restrictions: Cochrane Central Register of Controlled Trials in the Cochrane Library, OvidSP Medline and Epub Ahead of Print, In-Process & Other Non-Indexed Citations and Daily; OvidSP Embase Classic+Embase; Ebsco CINAHL Plus, complete database; WHO International Clinical Trials Registry Platform search portal. We will include controlled and uncontrolled clinical trials along with any prospective or retrospective study that includes a universal cohort (all participants from a centre/region/city over a certain period). Cases series and cross-sectional studies are excluded. Two review authors will independently assess the trial eligibility, risk of bias and extract appropriate data points. The outcomes included in this review are: patient survival, acute graft rejection, chronic graft rejection, diabetes, graft function, graft loss, chronic graft versus host disease, acute graft versus host disease, surgical complications, infusion complications, post-transplant lymphoproliferative disease, liver function, renal function, cognition, depression, health-related quality of life, hospitalisation, high blood pressure, low blood pressure, cancer - other, cancer - skin, cardiovascular disease, bacterial infection, Epstein-Barr infection, cytomegalovirus infection, other viral infections and growth.
Lista de ficheros
Google Scholar:Martin Saborido, Carlos
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Borobia Pérez, Alberto M.
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Cobas, Javier
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D'Antiga, Lorenzo
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Frauca, Esteban
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Hernández-Oliveros, Francisco
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Jara, Paloma
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López-Granados, Eduardo
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Muñoz, Jose María
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Nicastro, Emanuele
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Ojeda, Jose Jonay
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Pérez Martínez, Antonio
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Torres, Juan Manuel
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Carcas Sansuán, Antonio Javier
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