Background: The neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) have been the focus of several observational studies investigating their roles in acute allograft rejection (AR) and delayed graft function (DGF) among kidney transplant (KT) recipients. This meta-analysis evaluated the impact of the NLR and PLR on the incidence of AR and DGF in KT recipients. Methods: We searched PubMed, MEDLINE and Science Direct from their inception through October 2023. Random effects models were used. To investigate potential sources of heterogeneity, we performed subgroup and meta-regression analyses. The Comprehensive Meta-Analysis ver. 3 software package was used. Results: Seven studies (247 KT recipients with AR or DGF and 475 controls) were analyzed. Our pooled analysis showed a significantly higher NLR in KT recipients with AR (weighted mean difference [WMD], 2.292; 95% confidence interval [CI], 1.449–3.135;P<0.001) than in controls. The preoperative NLR was insignificantly higher in patients with DGF (WMD, 0.871; 95% CI, –0.103 to 1.846; P=0.08). The PLR was insignificantly higher in KT recipients with AR than in controls (WMD, 32.125; 95% CI, –19.978 to 84.228; P=0.227). The PLR was not significantly different between KT recipients with DGF and controls. Region, publication year, sample size, donor type, biopsy type, AR type and Newcastle-Ottawa Scale score did not affect the outcomes of the meta-analysis. Meta-regression showed that publication year and donor type might be sources of heterogeneity. Conclusions This study revealed a significantly higher NLR in patients with AR. This suggests that NLR may be utilized as a noninvasive marker for AR in KT recipients.

Background: The neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) have been the focus of several observational studies investigating their roles in acute allograft rejection (AR) and delayed graft function (DGF) among kidney transplant (KT) recipients. This meta-analysis evaluated the impact of the NLR and PLR on the incidence of AR and DGF in KT recipients. Methods: We searched PubMed, MEDLINE and Science Direct from their inception through October 2023. Random effects models were used. To investigate potential sources of heterogeneity, we performed subgroup and meta-regression analyses. The Comprehensive Meta-Analysis ver. 3 software package was used. Results: Seven studies (247 KT recipients with AR or DGF and 475 controls) were analyzed. Our pooled analysis showed a significantly higher NLR in KT recipients with AR (weighted mean difference [WMD], 2.292; 95% confidence interval [CI], 1.449–3.135;P<0.001) than in controls. The preoperative NLR was insignificantly higher in patients with DGF (WMD, 0.871; 95% CI, –0.103 to 1.846; P=0.08). The PLR was insignificantly higher in KT recipients with AR than in controls (WMD, 32.125; 95% CI, –19.978 to 84.228; P=0.227). The PLR was not significantly different between KT recipients with DGF and controls. Region, publication year, sample size, donor type, biopsy type, AR type and Newcastle-Ottawa Scale score did not affect the outcomes of the meta-analysis. Meta-regression showed that publication year and donor type might be sources of heterogeneity. Conclusions This study revealed a significantly higher NLR in patients with AR. This suggests that NLR may be utilized as a noninvasive marker for AR in KT recipients.

Background: The neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) have been the focus of several observational studies investigating their roles in acute allograft rejection (AR) and delayed graft function (DGF) among kidney transplant (KT) recipients. This meta-analysis evaluated the impact of the NLR and PLR on the incidence of AR and DGF in KT recipients. Methods: We searched PubMed, MEDLINE and Science Direct from their inception through October 2023. Random effects models were used. To investigate potential sources of heterogeneity, we performed subgroup and meta-regression analyses. The Comprehensive Meta-Analysis ver. 3 software package was used. Results: Seven studies (247 KT recipients with AR or DGF and 475 controls) were analyzed. Our pooled analysis showed a significantly higher NLR in KT recipients with AR (weighted mean difference [WMD], 2.292; 95% confidence interval [CI], 1.449–3.135;P<0.001) than in controls. The preoperative NLR was insignificantly higher in patients with DGF (WMD, 0.871; 95% CI, –0.103 to 1.846; P=0.08). The PLR was insignificantly higher in KT recipients with AR than in controls (WMD, 32.125; 95% CI, –19.978 to 84.228; P=0.227). The PLR was not significantly different between KT recipients with DGF and controls. Region, publication year, sample size, donor type, biopsy type, AR type and Newcastle-Ottawa Scale score did not affect the outcomes of the meta-analysis. Meta-regression showed that publication year and donor type might be sources of heterogeneity. Conclusions This study revealed a significantly higher NLR in patients with AR. This suggests that NLR may be utilized as a noninvasive marker for AR in KT recipients.

Background: The neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) have been the focus of several observational studies investigating their roles in acute allograft rejection (AR) and delayed graft function (DGF) among kidney transplant (KT) recipients. This meta-analysis evaluated the impact of the NLR and PLR on the incidence of AR and DGF in KT recipients. Methods: We searched PubMed, MEDLINE and Science Direct from their inception through October 2023. Random effects models were used. To investigate potential sources of heterogeneity, we performed subgroup and meta-regression analyses. The Comprehensive Meta-Analysis ver. 3 software package was used. Results: Seven studies (247 KT recipients with AR or DGF and 475 controls) were analyzed. Our pooled analysis showed a significantly higher NLR in KT recipients with AR (weighted mean difference [WMD], 2.292; 95% confidence interval [CI], 1.449–3.135;P<0.001) than in controls. The preoperative NLR was insignificantly higher in patients with DGF (WMD, 0.871; 95% CI, –0.103 to 1.846; P=0.08). The PLR was insignificantly higher in KT recipients with AR than in controls (WMD, 32.125; 95% CI, –19.978 to 84.228; P=0.227). The PLR was not significantly different between KT recipients with DGF and controls. Region, publication year, sample size, donor type, biopsy type, AR type and Newcastle-Ottawa Scale score did not affect the outcomes of the meta-analysis. Meta-regression showed that publication year and donor type might be sources of heterogeneity. Conclusions This study revealed a significantly higher NLR in patients with AR. This suggests that NLR may be utilized as a noninvasive marker for AR in KT recipients.

Background: Ureteral stenting is commonly performed after ureteral neoimplantation during kidney transplantation to reduce major urological complications (MUCs). However, the optimal duration of ureteral stent removal remains unclear, as longer stenting is associated with increased risk of urinary tract infection (UTI). This study comparedUTI and MUC incidence between early (≤3 weeks) and late (>3 weeks) stent removal fol-lowing living donor kidney transplantation (LDKT). Methods: We systematically searched the PubMed/MEDLINE, Science Direct, Cochrane, and EMBASE databases through January 2024 for randomized and observationalstudies comparing early (≤3 weeks) and late (>3 weeks) ureteral stent removal in LDKTrecipients. The following Medical Subject Headings were used for the search: “kidney transplantation,” “renal transplantation,” and “ureteral stent” or “stent”. Stenting duration, UTI incidence, and MUCs (obstruction and urinary leakage) were recorded, and a meta-analysis was performed to pool odds ratios (ORs). Results: Eight studies (five randomized controlled trials and three cohort studies) comprising 2,148 LDKT recipients were included. Early removal significantly reduced the incidence of UTIs compared with late removal (OR, 0.53; 95% confidence interval [CI], 0.32–0.87). Six studies assessed MUC incidence, revealing no significant difference between early and late removal (OR, 0.69; 95% CI, 0.28–1.65). Subgroup analysis demonstrated that early stent removal does not increase the risk of obstruction (OR, 0.76; 95% CI, 0.22–2.66) or urinary leakage (OR, 0.62; 95% CI, 0.18–2.14) compared with late removal. Conclusions Performing ureteral stent removal less than 3 weeks after LDKT reduces UTI risk without increasing MUCs relative to later removal.