Use of induction therapy post-heart transplantation: Clinical practice recommendations based on systematic review and network meta-analysis of evidence

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dc.contributor.authorForoutan, Farid
dc.contributor.authorGuyatt, Gordon
dc.contributor.authorStehlik, Josef
dc.contributor.authorGustafsson, Finn
dc.contributor.authorGreig, Douglas
dc.contributor.authorMcdonald, Michael
dc.contributor.authorBertolotti, Alejandro Mario
dc.contributor.authorKugathasan, Lakshmi
dc.contributor.authorRayner, Daniel G.
dc.contributor.authorCuello, Carlos A.
dc.contributor.authorCook, Amanda
dc.contributor.authorZlatanoski, Darko
dc.contributor.authorRam, Sujivan
dc.contributor.authorDemas-Clarke, Penny
dc.contributor.authorKozuszko, Stella
dc.contributor.authorAlba, Ana Carolina
dc.date.accessioned2025-01-20T17:08:21Z
dc.date.available2025-01-20T17:08:21Z
dc.date.issued2024
dc.description.abstractBackgroundThe use of induction therapy (IT) agents in the early post-heart transplant period remains controversial. The following recommendations aim to provide guidance on the use of IT agents, including Basiliximab and Thymoglobulin, as part of routine care in heart transplantation (HTx).MethodsWe recruited an international, multidisciplinary panel of 15 stakeholders, including patient partners, transplant cardiologists and surgeons, nurse practitioners, pharmacists, and methodologists. We commissioned a systematic review on benefits and harms of IT on patient-important outcomes, and another on patients' values and preferences to inform our recommendations. We used the GRADE framework to summarize our findings, rate certainty in the evidence, and develop recommendations. The panel considered the balance between benefits and harms, certainty in the evidence, and patient's values and preferences, to make recommendations for or against the routine post-operative use of Thymoglobulin or Basiliximab.ResultsThe panel made recommendations on three major clinical problems in HTx: (1) We suggest against the routine post-operative use of Basiliximab compared to no IT, (2) we suggest against the routine use of Thymoglobulin compared to no IT, and (3) for those patients for whom IT is deemed desirable, we suggest for the use of Thymoglobulin as compared to Basiliximab.ConclusionThis report highlights gaps in current knowledge and provides directions for clinical research in the future to better understand the clinical utility of IT agents in the early post heart transplant period, leading to improved management and care.
dc.fuente.origenWOS
dc.identifier.doi10.1111/ctr.15270
dc.identifier.eissn1399-0012
dc.identifier.issn0902-0063
dc.identifier.urihttps://doi.org/10.1111/ctr.15270
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/90941
dc.identifier.wosidWOS:001179161200001
dc.issue.numero3
dc.language.isoen
dc.revistaClinical transplantation
dc.rightsacceso restringido
dc.subjectBasilixmab
dc.subjectheart transplantation
dc.subjectinduction therapy
dc.subjectThymoglobulin
dc.subject.ods03 Good Health and Well-being
dc.subject.odspa03 Salud y bienestar
dc.titleUse of induction therapy post-heart transplantation: Clinical practice recommendations based on systematic review and network meta-analysis of evidence
dc.typeartículo
dc.volumen38
sipa.indexWOS
sipa.trazabilidadWOS;2025-01-12
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