Omega-3 Fatty Acid Supplementation in Solid Organ Transplant Recipients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Background: Omega-3 polyunsaturated fatty acids are known for anti-inflammatory and cardiovascular benefits, but their impact on solid organ transplant outcomes is unclear.

Objectives: To assess the effects of omega-3 supplementation on clinical outcomes in solid organ transplant recipients.

Methods: A systematic review and meta-analysis of randomized controlled trials was conducted according to PRISMA guidelines. Databases including PubMed, Scopus, and Web of Science were searched through May 2025. Eligible studies were evaluated for transplant-related outcomes, with the primary outcome being graft rejection at 30-day, 3-month, and 1-year post-transplant. Secondary outcomes included changes in lipid profile, blood pressure, renal function, and infection rates.

Results: Sixteen trials involving 1,020 patients were included. Omega-3 supplementation did not result in a statistically significant reduction in rejection rates at 30 days, 3 months, or 1 year post-transplant. Diastolic blood pressure decreased significantly (Hedges' g = -0.72; 95% CI: -1.31 to -0.13), and total cholesterol levels also declined (Hedges' g = -0.64; 95% CI: -1.04 to -0.24), particularly in kidney transplant recipients. In heart transplant recipients, systolic blood pressure decreased significantly (Hedges' g = -1.03; 95% confidence interval: -1.53 to -0.54). Effects on high- and low-density lipoproteins, triglycerides, glomerular filtration rate, and creatinine clearance were inconsistent and largely non-significant. A single study reported reduced sepsis rates in kidney recipients (log odds ratio = -1.16; 95% confidence interval: -2.25 to -0.07). No significant impact was seen on calcineurin inhibitor toxicity.

Conclusion: Omega-3 supplementation may have benefits for solid organ transplant recipients in terms of improving lipid profiles and reducing blood pressure. However, study heterogeneity and limited outcome data highlight the need for larger, standardized trials.