Clinical Outcomes and Contributors in Contemporary Kidney Transplantation: Single Center Experience.
10.4285/jkstn.2017.31.4.182
- Author:
Jae Sung AHN
1
;
Kyung Sun PARK
;
Jongha PARK
;
Hyun Chul CHUNG
;
Hojong PARK
;
Sang Jun PARK
;
Hong Rae CHO
;
Jong Soo LEE
Author Information
1. Division of Nephrology, Department of Internal Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea. jslee@uuh.ulsan.kr
- Publication Type:Original Article
- Keywords:
Long-term outcomes;
Kidney transplantation;
Acute rejection
- MeSH:
Follow-Up Studies;
Graft Survival;
Humans;
Immunosuppressive Agents;
Kidney Transplantation*;
Kidney*;
Retrospective Studies;
Risk Factors;
Survival Rate;
Tissue Donors;
Transplants;
Ulsan
- From:The Journal of the Korean Society for Transplantation
2017;31(4):182-192
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: In recent years, introduction of novel immunosuppressive agents and its proper implementation for clinical practice have contributed to improving clinical outcomes of kidney transplantation (KT). Here, we report clinical outcomes of KTs and related risk factors. METHODS: From July 1998 to June 2016, 354 KTs (182 from living and 172 from deceased donors) have been performed at Ulsan University Hospital. We retrospectively reviewed the clinical characteristics and outcomes of KT recipients, then estimated graft and patient survival rate were estimated and analyzed risk factors using Cox-regression. RESULTS: The median follow-up period was 53 months (range; 3 to 220 months). The mean ages of recipients and donors were 45.0 years (SD, 12.5) and 44.7 years (SD, 13.6) years, respectively. During follow-up, 18 grafts were lost and 5- and 10-year death-censored graft survival was 96.7% and 91.5%, respectively. Biopsy-proven acute rejection (BPAR) occurred in 71 patients (55 cases of acute cellular rejection and 16 of antibody-mediated rejection). Cox-regression analysis showed that BPAR was a risk factor related to graft loss (hazard ratio [HR], 14.38; 95% confidence interval [CI], 3.79 to 54.53; P < 0.001). In addition, 15 patients died, and the 5- and 10-year patient survival was 97.2% and 91.9%, respectively. Age ≥60 years (HR, 6.03; 95% CI, 1.12 to 32.61; P=0.037) and diabetes (HR, 6.18; 95% CI, 1.35 to 28.22; P=0.019) were significantly related to patient survival. CONCLUSIONS: We experienced excellent clinical outcomes of KT in terms of graft failure and patient survival despite the relatively high proportion of deceased donors. Long-term and short-term clinical outcomes have improved in the last two decades.
