Late-onset pneumocystis pneumonia after kidney transplantation: A systematic review and meta-analysis of prevalence, risk factors, and outcomes.
Konwai, S., et al.Transplant Rev (Orlando). 2026 Jan;40(1):100972.
Aims
This study aimed to synthesise evidence on prevalence, outcomes and risk factors associated with late-onset Pneumocystis jirovecii pneumonia (PCP) in kidney transplant recipients.
Interventions
MEDLINE, Scopus, and the Cochrane Central Register of Controlled Trials databases were searched for relevant literature. Screening of titles and abstracts followed by data extraction were performed by two reviewers. The Newcastle–Ottawa Scale (NOS) for case-control and cohort studies was used to assess the quality of the included studies.
Participants
24 studies were included in the review.
Outcomes
The main outcomes of interest included prevalence, risk factors, graft loss and mortality rate of late onset-PCP.
Follow-up
N/A
CET Conclusions
This is an interesting and well-conducted, comprehensive systematic review. The search strategy was wide and appropriate, with dual data extraction and study selection. Meta analysis methods were appropriate. Late-onset PCP persists in renal transplant recipients, albeit at a low level, with risk factors including ABO incompatible transplant, low lymphocyte count, rejection history, and rituximab use.
Trial registration
PROSPERO - CRD420251067873