Predictors of Avascular Necrosis after Kidney Transplantation.
10.4285/jkstn.2017.31.4.200
- Author:
Young Min KO
1
;
Hyunwook KWON
;
Sung Jin CHUN
;
Young Hoon KIM
;
Ji Yoon CHOI
;
Sung SHIN
;
Joo Hee JUNG
;
Su Kil PARK
;
Duck Jong HAN
Author Information
1. Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. djhan@amc.seoul.kr
- Publication Type:Original Article
- Keywords:
Osteonecrosis;
Kidney transplantation;
Female;
Immunosuppression
- MeSH:
Chungcheongnam-do;
Female;
Follow-Up Studies;
Graft Survival;
Humans;
Immunosuppression;
Incidence;
Kidney Transplantation*;
Kidney*;
Multivariate Analysis;
Necrosis*;
Osteonecrosis;
Retrospective Studies;
Risk Factors
- From:The Journal of the Korean Society for Transplantation
2017;31(4):200-206
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: Risk factors for bone avascular necrosis (AVN), a common late complication after kidney transplantation (KT), are not well known. METHODS: Patients that underwent living-donor KT at Asan Medical Center between January 2009 and July 2016 were included in this retrospective study to determine the incidence and risk factors for AVN after KT. RESULTS: Among 1,570 patients that underwent living-donor KT, 33 (2.1%) developed AVN during a mean follow-up of 49.8±25.0months. Additionally, AVN was diagnosed at a mean of 13.9±6.6 months after KT. The mean cumulative corticosteroid dose during the last follow-up in patients without AVN (9,108±3,400 mg) was higher than that that in patients with AVN (4,483±1,114 mg) until AVN development (P < 0.01). More patients among those with AVN (n=4, 12.1%) underwent steroid pulse treatment because of biopsy-proven rejections during the first 6 months after KT than patients without AVN (n=68, 4.4%; P=0.04). Female (hazard ratio [HR], 2.29; P=0.04) and steroid pulse treatment during the first 6 months (HR, 2.31; P=0.02) were significant AVN risk factors as revealed by the Cox proportional multivariate analysis. However, no significant differences in rejection-free graft survival rates were observed between the two groups (P=0.67). CONCLUSIONS: Steroid pulse treatment within 6 months of KT and being female were independent risk factors for AVN development.
