Weight gain, overweight and obesity in solid organ transplantation—a study protocol for a systematic literature review

Abstract

BackgroundOverweight and obesity, which have a substantial impact on health in the general population, have similar prevalence in solid organ transplant recipients but carry even more serious ramifications. As this group’s use of immunosuppressive medication increases the risk for comorbidities, e.g. metabolic syndrome and cardiovascular disease, the prevention of additional risk factors is vital. This systematic review will be the first to summarize the issue of weight gain, overweight and obesity concurrently within and across solid organ transplantation. The three research questions relating to solid organ transplantation are the following: (1) What are the prevalence and evolution of overweight and obesity from pre- to post-transplant?; (2) Which pre- and post-transplant risk factors are associated with post-transplant weight gain, overweight or obesity? and (3) Which post-transplant patient outcomes and comorbidities are associated with pre- and post-transplant weight gain, overweight and obesity?Methods/DesignMEDLINE via PubMed, The Cochrane Library, Cumulative Index to Nursing and Allied Health (CINAHL), PsycINFO and Excerpta Medica DataBase (EMBASE) will be searched for original quantitative studies in adult liver, heart, lung or kidney transplant patients. Topics of interest will be the prevalence and evolution of overweight and obesity over time, risk factors associated with changes in weight or body mass index (BMI), overweight and obesity, and the relationship of weight or BMI with post-transplant outcomes and comorbidities. Screening of titles and abstracts, full-text reading and data extraction will be divided between three researchers. Researchers will cross-check one another’s screening decisions for random samples of studies to adhere as closely as possible to the recommendations of The Cochrane Collaboration. For quality assessment, a purpose-adapted 19-item instrument will be used. Effect sizes will be calculated for relationships investigated in a minimum of five studies. Random effects meta-analysis with moderator analyses will be conducted if applicable.DiscussionThis systematic review will comprehensively synthesize the existing evidence concerning weight gain, overweight and obesity in solid organ transplantation in view of magnitude, influencing factors and associations with patient outcomes and comorbidities. The results can fuel the development of interventions to prevent weight gain in the solid organ transplant population.Systematic review registrationPROSPERO CRD42014009151Electronic supplementary materialThe online version of this article (doi:10.1186/2046-4053-4-2) contains supplementary material, which is available to authorized users.

Obesity After Kidney Transplantation—Results of a KTx360°Substudy

“…Above that, the immunosuppressive medication might support weight gain after KTx. While the findings on corticosteroids in maintenance dose and weight gain after KTx seem inconsistent (15), calcineurin inhibitors are known to support new-onset diabetes after transplantation (NODAT) which also supports further weight gain (16).…”

Pre- and post-transplant factors associated with body weight parameters after liver transplantation – A systematic review and meta-analysis

“…Reporting was structured according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses: PRISMA statement [23]. The review protocol was registered in the international prospective register of systematic reviews (PROSPERO, registration number: CRD42014009151) and published [24].…”

“…The first search was conducted March 17, 2014 and updated February 3, 2016. As the project aimed to examine risk factors related to body weight parameters in kidney, liver, heart and lung transplant populations, the search strategy included all solid organ groups [24]. However, this article only reports the risk factors affecting the LTx population.…”

Weighted Genetic Risk Scores and Prediction of Weight Gain in Solid Organ Transplant Populations

“…Regarding BMI-related phenotypes, a protocol for the first systematic literature review has been published. The aim is to condense and compare the current state of evidence on WG, overweight and obesity in SOT individuals including genetic and non-genetic factors [21]. Regarding candidate gene approach, two single nucleotide polymorphisms (SNPs) and one insertion/deletion have previously been associated with BMI-related phenotypes [22–24].…”