Purpose: Pancreas transplantation (PT) is a definitive treatment for diabetes mellitus (DM), restoring endogenous insulin secretion and improving glycemic control. Despite its efficacy, PT is less common in South Korea compared to Western nations. This study aims to report the clinical outcomes of PT over 2 decades at a single center, focusing on surgical techniques, complications, and graft survival. Methods: A retrospective analysis of 69 PT recipients at Seoul National University Hospital between January 2002 and December 2023 was conducted. Data on recipient and donor demographics, surgical details, immunosuppressive regimens, and graft outcomes were collected. Graft survival was evaluated using Kaplan-Meier analysis, with subgroup comparisons using the log-rank test. Graft failure was defined as graft removal, PT re-registration, insulin dependence exceeding 0.5 units/kg/day for more than 90 days, or patient death. Results: Among the 69 recipients, 50 (72.5%) had type 1 DM, and 18 (26.1%) had type 2 DM. Simultaneous pancreaskidney (SPK) transplantations comprised 84.1% (n = 58), and pancreas-after-kidney (PAK) transplantations accounted for 10.1%. The 1-year and 5-year death-censored pancreas graft survival rates were 92.7% and 89.6%, respectively, with no significant difference between SPK and PAK (P = 0.330). Graft failure occurred in 10 patients, primarily due to pancreatitis and rejection. Donor-related factors, particularly anoxic brain injury, were significantly associated with lower graft survival (P = 0.045). Conclusion PT outcomes in this cohort align with international standards, emphasizing the importance of donor selection and tailored immunosuppression. Expanding PT indications to include selective type 2 DM patients could benefit South Korea’s PT programs with adequate resource allocation.

Purpose: Pancreas transplantation (PT) is a definitive treatment for diabetes mellitus (DM), restoring endogenous insulin secretion and improving glycemic control. Despite its efficacy, PT is less common in South Korea compared to Western nations. This study aims to report the clinical outcomes of PT over 2 decades at a single center, focusing on surgical techniques, complications, and graft survival. Methods: A retrospective analysis of 69 PT recipients at Seoul National University Hospital between January 2002 and December 2023 was conducted. Data on recipient and donor demographics, surgical details, immunosuppressive regimens, and graft outcomes were collected. Graft survival was evaluated using Kaplan-Meier analysis, with subgroup comparisons using the log-rank test. Graft failure was defined as graft removal, PT re-registration, insulin dependence exceeding 0.5 units/kg/day for more than 90 days, or patient death. Results: Among the 69 recipients, 50 (72.5%) had type 1 DM, and 18 (26.1%) had type 2 DM. Simultaneous pancreaskidney (SPK) transplantations comprised 84.1% (n = 58), and pancreas-after-kidney (PAK) transplantations accounted for 10.1%. The 1-year and 5-year death-censored pancreas graft survival rates were 92.7% and 89.6%, respectively, with no significant difference between SPK and PAK (P = 0.330). Graft failure occurred in 10 patients, primarily due to pancreatitis and rejection. Donor-related factors, particularly anoxic brain injury, were significantly associated with lower graft survival (P = 0.045). Conclusion PT outcomes in this cohort align with international standards, emphasizing the importance of donor selection and tailored immunosuppression. Expanding PT indications to include selective type 2 DM patients could benefit South Korea’s PT programs with adequate resource allocation.

Purpose: Pancreas transplantation (PT) is a definitive treatment for diabetes mellitus (DM), restoring endogenous insulin secretion and improving glycemic control. Despite its efficacy, PT is less common in South Korea compared to Western nations. This study aims to report the clinical outcomes of PT over 2 decades at a single center, focusing on surgical techniques, complications, and graft survival. Methods: A retrospective analysis of 69 PT recipients at Seoul National University Hospital between January 2002 and December 2023 was conducted. Data on recipient and donor demographics, surgical details, immunosuppressive regimens, and graft outcomes were collected. Graft survival was evaluated using Kaplan-Meier analysis, with subgroup comparisons using the log-rank test. Graft failure was defined as graft removal, PT re-registration, insulin dependence exceeding 0.5 units/kg/day for more than 90 days, or patient death. Results: Among the 69 recipients, 50 (72.5%) had type 1 DM, and 18 (26.1%) had type 2 DM. Simultaneous pancreaskidney (SPK) transplantations comprised 84.1% (n = 58), and pancreas-after-kidney (PAK) transplantations accounted for 10.1%. The 1-year and 5-year death-censored pancreas graft survival rates were 92.7% and 89.6%, respectively, with no significant difference between SPK and PAK (P = 0.330). Graft failure occurred in 10 patients, primarily due to pancreatitis and rejection. Donor-related factors, particularly anoxic brain injury, were significantly associated with lower graft survival (P = 0.045). Conclusion PT outcomes in this cohort align with international standards, emphasizing the importance of donor selection and tailored immunosuppression. Expanding PT indications to include selective type 2 DM patients could benefit South Korea’s PT programs with adequate resource allocation.

Purpose: Takayasu arteritis (TAK) is a rare form of chronic vasculitis that is common in Asian female. As TAK predominantly affects young female with a longer life expectancy than those with atherosclerotic diseases, assessing the specific long-term outcomes of TAK treatment is important. Therefore, this study aimed to evaluate the long-term outcomes and post-procedural complications of surgical and endovascular treatment for TAK. Materials and Methods: This single-center retrospective observational study reviewed 545 consecutive patients diagnosed with TAK between 1983 and 2020 at Seoul National University Hospital. Of these, 56 patients who underwent 73 extracardiac interventions were enrolled in the study. The data included clinical features, angiographic and laboratory findings, treatment modalities, and clinical outcomes. Results: The mean age of the participants was 40.3±20.3 years, with a predominance of female (75.0%). The mean follow-up duration was 147.7±111.6 months. The most common comorbidity was hypertension (n=42, 75.0%), followed by heart failure (n=12, 21.4%). The most frequent symptom of TAK was uncontrolled hypertension (n=36, 64.3%). The renal artery (n=23, 31.5%) was the most frequently revascularized vessel, followed by the supra-aortic branches, including the innominate, subclavian, vertebral, and carotid arteries (n=19; 26.0%). In the endovascular group, the primary patency rates at 5, 10, and 20 years were 42.2%, 31.7%, and 17.0%, respectively. The rates in the surgical group were 84.4%, 75.7%, and 59.0%, respectively. This difference was statistically significant (P<0.001). The difference in the secondary patency rates between the two groups was not statistically significant. The most common early complication (≤1 month) was arterial dissection (n=4, 5.5%), whereas the most prevalent late complication (>1 month) was restenosis, which occurred significantly more frequently in the endovascular group than in the surgical group (55.0% vs.12.1%, P<0.001). Conclusion Surgical and endovascular treatments for TAK are safe. However, restenosis develops more frequently after endovascular treatment compared to surgical treatment, particularly within the first three years. Increased periodic serial monitoring is recommended during this period.

Purpose: Takayasu arteritis (TAK) is a rare form of chronic vasculitis that is common in Asian female. As TAK predominantly affects young female with a longer life expectancy than those with atherosclerotic diseases, assessing the specific long-term outcomes of TAK treatment is important. Therefore, this study aimed to evaluate the long-term outcomes and post-procedural complications of surgical and endovascular treatment for TAK. Materials and Methods: This single-center retrospective observational study reviewed 545 consecutive patients diagnosed with TAK between 1983 and 2020 at Seoul National University Hospital. Of these, 56 patients who underwent 73 extracardiac interventions were enrolled in the study. The data included clinical features, angiographic and laboratory findings, treatment modalities, and clinical outcomes. Results: The mean age of the participants was 40.3±20.3 years, with a predominance of female (75.0%). The mean follow-up duration was 147.7±111.6 months. The most common comorbidity was hypertension (n=42, 75.0%), followed by heart failure (n=12, 21.4%). The most frequent symptom of TAK was uncontrolled hypertension (n=36, 64.3%). The renal artery (n=23, 31.5%) was the most frequently revascularized vessel, followed by the supra-aortic branches, including the innominate, subclavian, vertebral, and carotid arteries (n=19; 26.0%). In the endovascular group, the primary patency rates at 5, 10, and 20 years were 42.2%, 31.7%, and 17.0%, respectively. The rates in the surgical group were 84.4%, 75.7%, and 59.0%, respectively. This difference was statistically significant (P<0.001). The difference in the secondary patency rates between the two groups was not statistically significant. The most common early complication (≤1 month) was arterial dissection (n=4, 5.5%), whereas the most prevalent late complication (>1 month) was restenosis, which occurred significantly more frequently in the endovascular group than in the surgical group (55.0% vs.12.1%, P<0.001). Conclusion Surgical and endovascular treatments for TAK are safe. However, restenosis develops more frequently after endovascular treatment compared to surgical treatment, particularly within the first three years. Increased periodic serial monitoring is recommended during this period.

Purpose: Takayasu arteritis (TAK) is a rare form of chronic vasculitis that is common in Asian female. As TAK predominantly affects young female with a longer life expectancy than those with atherosclerotic diseases, assessing the specific long-term outcomes of TAK treatment is important. Therefore, this study aimed to evaluate the long-term outcomes and post-procedural complications of surgical and endovascular treatment for TAK. Materials and Methods: This single-center retrospective observational study reviewed 545 consecutive patients diagnosed with TAK between 1983 and 2020 at Seoul National University Hospital. Of these, 56 patients who underwent 73 extracardiac interventions were enrolled in the study. The data included clinical features, angiographic and laboratory findings, treatment modalities, and clinical outcomes. Results: The mean age of the participants was 40.3±20.3 years, with a predominance of female (75.0%). The mean follow-up duration was 147.7±111.6 months. The most common comorbidity was hypertension (n=42, 75.0%), followed by heart failure (n=12, 21.4%). The most frequent symptom of TAK was uncontrolled hypertension (n=36, 64.3%). The renal artery (n=23, 31.5%) was the most frequently revascularized vessel, followed by the supra-aortic branches, including the innominate, subclavian, vertebral, and carotid arteries (n=19; 26.0%). In the endovascular group, the primary patency rates at 5, 10, and 20 years were 42.2%, 31.7%, and 17.0%, respectively. The rates in the surgical group were 84.4%, 75.7%, and 59.0%, respectively. This difference was statistically significant (P<0.001). The difference in the secondary patency rates between the two groups was not statistically significant. The most common early complication (≤1 month) was arterial dissection (n=4, 5.5%), whereas the most prevalent late complication (>1 month) was restenosis, which occurred significantly more frequently in the endovascular group than in the surgical group (55.0% vs.12.1%, P<0.001). Conclusion Surgical and endovascular treatments for TAK are safe. However, restenosis develops more frequently after endovascular treatment compared to surgical treatment, particularly within the first three years. Increased periodic serial monitoring is recommended during this period.

Purpose: Takayasu arteritis (TAK) is a rare form of chronic vasculitis that is common in Asian female. As TAK predominantly affects young female with a longer life expectancy than those with atherosclerotic diseases, assessing the specific long-term outcomes of TAK treatment is important. Therefore, this study aimed to evaluate the long-term outcomes and post-procedural complications of surgical and endovascular treatment for TAK. Materials and Methods: This single-center retrospective observational study reviewed 545 consecutive patients diagnosed with TAK between 1983 and 2020 at Seoul National University Hospital. Of these, 56 patients who underwent 73 extracardiac interventions were enrolled in the study. The data included clinical features, angiographic and laboratory findings, treatment modalities, and clinical outcomes. Results: The mean age of the participants was 40.3±20.3 years, with a predominance of female (75.0%). The mean follow-up duration was 147.7±111.6 months. The most common comorbidity was hypertension (n=42, 75.0%), followed by heart failure (n=12, 21.4%). The most frequent symptom of TAK was uncontrolled hypertension (n=36, 64.3%). The renal artery (n=23, 31.5%) was the most frequently revascularized vessel, followed by the supra-aortic branches, including the innominate, subclavian, vertebral, and carotid arteries (n=19; 26.0%). In the endovascular group, the primary patency rates at 5, 10, and 20 years were 42.2%, 31.7%, and 17.0%, respectively. The rates in the surgical group were 84.4%, 75.7%, and 59.0%, respectively. This difference was statistically significant (P<0.001). The difference in the secondary patency rates between the two groups was not statistically significant. The most common early complication (≤1 month) was arterial dissection (n=4, 5.5%), whereas the most prevalent late complication (>1 month) was restenosis, which occurred significantly more frequently in the endovascular group than in the surgical group (55.0% vs.12.1%, P<0.001). Conclusion Surgical and endovascular treatments for TAK are safe. However, restenosis develops more frequently after endovascular treatment compared to surgical treatment, particularly within the first three years. Increased periodic serial monitoring is recommended during this period.

Purpose: Takayasu arteritis (TAK) is a rare form of chronic vasculitis that is common in Asian female. As TAK predominantly affects young female with a longer life expectancy than those with atherosclerotic diseases, assessing the specific long-term outcomes of TAK treatment is important. Therefore, this study aimed to evaluate the long-term outcomes and post-procedural complications of surgical and endovascular treatment for TAK. Materials and Methods: This single-center retrospective observational study reviewed 545 consecutive patients diagnosed with TAK between 1983 and 2020 at Seoul National University Hospital. Of these, 56 patients who underwent 73 extracardiac interventions were enrolled in the study. The data included clinical features, angiographic and laboratory findings, treatment modalities, and clinical outcomes. Results: The mean age of the participants was 40.3±20.3 years, with a predominance of female (75.0%). The mean follow-up duration was 147.7±111.6 months. The most common comorbidity was hypertension (n=42, 75.0%), followed by heart failure (n=12, 21.4%). The most frequent symptom of TAK was uncontrolled hypertension (n=36, 64.3%). The renal artery (n=23, 31.5%) was the most frequently revascularized vessel, followed by the supra-aortic branches, including the innominate, subclavian, vertebral, and carotid arteries (n=19; 26.0%). In the endovascular group, the primary patency rates at 5, 10, and 20 years were 42.2%, 31.7%, and 17.0%, respectively. The rates in the surgical group were 84.4%, 75.7%, and 59.0%, respectively. This difference was statistically significant (P<0.001). The difference in the secondary patency rates between the two groups was not statistically significant. The most common early complication (≤1 month) was arterial dissection (n=4, 5.5%), whereas the most prevalent late complication (>1 month) was restenosis, which occurred significantly more frequently in the endovascular group than in the surgical group (55.0% vs.12.1%, P<0.001). Conclusion Surgical and endovascular treatments for TAK are safe. However, restenosis develops more frequently after endovascular treatment compared to surgical treatment, particularly within the first three years. Increased periodic serial monitoring is recommended during this period.

Background/Aims: Pneumocystis jirovecii pneumonia (PJP) is a rare but potentially fatal infection. This study was conducted to investigate the risk factors for PJP in inflammatory bowel disease (IBD) patients. Methods: This nationwide, population-based study was conducted in Korea using claims data.Cases of PJP were identified in patients diagnosed with ulcerative colitis (UC) or Crohn’s disease (CD) between 2010 and 2017, and the clinical data of each patient was analyzed. Dual and triple therapy was defined as the simultaneous prescription of two or three of the following drugs: steroids, calcineurin inhibitors, immunomodulators, and biologics. Results: During the mean follow-up period (4.6±2.3 years), 84 cases of PJP were identified in 39,462 IBD patients (31 CD and 53 UC). For CD patients, only age at diagnosis >40 years (hazard ratio [HR], 6.12; 95% confidence interval [CI], 1.58 to 23.80) was significantly associated with the risk of PJP, whereas in UC patients, diagnoses of diabetes (HR, 2.51; 95% CI, 1.19 to 5.31) and chronic obstructive pulmonary disease (HR, 3.41; 95% CI, 1.78 to 6.52) showed significant associations with PJP risk. Triple therapy increased PJP risk in both UC (HR, 3.90; 95% CI, 1.54 to 9.88) and CD patients (HR, 5.69; 95% CI, 2.32 to 14.48). However, dual therapy increased PJP risk only in UC patients (HR, 2.53; 95% CI, 1.36 to 4.70). Additionally, 23 patients (27%) received intensive care treatment, and 10 (12%) died within 30 days. Conclusions PJP risk factors differ in CD and UC patients. Considering the potential fatality of PJP, prophylaxis should be considered for at-risk IBD patients

Background: and PurposeGiant-cell arteritis (GCA) is the most common type of vasculitis in the elderly and is associated with high risks of visual loss and recurrence. Owing to its rarity in Asian populations, the current clinical interventions for these patients are not well known. Here we aimed to characterize the current management status of patients with GCA using Korean multicenter data. Methods: This retrospective study analyzed medical records of patients with GCA at six Korean university hospitals from February 2009 to November 2022. GCA had originally been diagnosed based on the 1990 American College of Rheumatology (ACR) criteria, and cases were selected for inclusion in this study based on the 2022 ACR/European Alliance of Associations for Rheumatology criteria. We evaluated treatments, follow-up periods, and outcomes (relapse, remission, and adverse drug reactions) in patients with GCA with or without arteritic anterior ischemic optic neuropathy (AAION). Results: This study analyzed 18 patients with a median age of 75.5 years that included 12 females (66.7%). Seven patients (38.8%) had AAION. All patients initially received prednisolone treatment, while four (22.2%) underwent adjuvant treatment with methotrexate and azathioprine during prednisolone tapering. During the median follow-up of 3.5 months (interquartile range: 2.0–23.2 months), 4 patients (22.2%) had prednisolone-related adverse reactions, 2 (11.1%) relapsed, and 13 (72.3%) dropped out. Nine patients (50.0%) experienced remission, with this being sustained in four (36.4%). Conclusions This study observed high dropout rates and short follow-ups. Adverse effects of prednisolone were common, and relapses occurred in approximately one-tenth of Korean patients with GCA. Thus, optimizing GCA treatment necessitates regular monitoring and long-term follow-up.