Recombinant Human Erythropoietin for Kidney Transplantation: A Systematic Review and Meta-Analysis

The protective effect of recombinant human erythropoietin (rHuEPO) on kidney transplantation has not been established. Therefore, we conducted a systematic review and meta-analysis to evaluate the potential influ-ence of rHuEPO on transplanted kidneys.

To identify relevant studies, we searched electronic databases (PubMed, Medline, EM-BASE, Ovid, the Cochrane Library, and major nephrology journals) from inception until June 15, 2018. Two inde-pendent reviewers assessed study quality. The systematic review and meta-analysis were performed with fixed- or random-effects models according to heterogeneity, and results are expressed as risk ratios (RR) or weighted mean differences.

Six randomized controlled trials with a total of 435 patients met the inclusion criteria. rHuEPO, compared with placebo, had no statistically significant effect on delayed graft function (RR = 0.89, 95% confidence interval [CI] , 0.73 to 1.07; P = 0.22) and slow graft function (RR = 0.93, 95% CI, 0.60 to 1.43; P = 0.73). The rHuEPO and control groups did not differ in thromboembolic events, mortality, acute rejection, and blood transfusion. A significant difference was found in long-term estimated glomerular filtration rate (RR = 3.65, 95% CI, -4.45 to 11.75; P = 0.003).

Our findings suggests that rHuEPO has a limited nephroprotective effect in patients undergoing kid-ney transplantation and does not increase the susceptibility to adverse events.