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Clinical outcomes of ABO- and HLA-incompatible kidney transplantation: a nationwide cohort study

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Author(s)
Eun Jeong KoJi Hyun YuChul Woo YangByung Ha Chungthe Korean Organ Transplantation Registry Study Group
Keimyung Author(s)
Han, Seung Yeup
Department
Dept. of Internal Medicine (내과학)
Journal Title
Transplant International
Issued Date
2017
Volume
30
Issue
12
Keyword
ABO incompatibilitykidney transplantationsensitization
Abstract
This was a nationwide cohort study to investigate the impact of anti-A/B and donor-specific anti-HLA (HLA-DSA) antibodies on the clinical outcomes in kidney transplant recipients (KTRs). We classified a total of 1964 KTRs into four groups: transplants from ABO-incompatible donors (ABOi, n = 248); transplants in recipients with HLA-DSA (HLAi, n = 144); transplants from combined ABOi and HLAi donors (ABOi + HLAi, n = 31); and a control group for whom neither ABOi nor HLAi was applicable (CONT, n = 1541). We compared the incidence of biopsy-proven acute rejection (BPAR), allograft and patient survival rates. The incidence of BPAR was higher in the HLAi and ABOi + HLAi groups relative to the CONT group; in contrast, it was not higher in the ABOi group. Death-censored graft survival rates did not differ across the four groups. However, relative to the CONT group, patient survival rate was reduced in the ABOi and ABOi + HLAi groups, and with infection being the most common cause of death. Further, multivariable analysis revealed that desensitization therapy because of ABOi or HLAi was independent risk factors for patient mortality. HLAi was a more important risk factor for BPAR compared with ABOi. However, pretransplant desensitization therapy for either ABOi or HLAi significantly increased the risk of infection-related mortality.
Keimyung Author(s)(Kor)
한승엽
Publisher
School of Medicine (의과대학)
Citation
Eun Jeong Ko et al. (2017). Clinical outcomes of ABO- and HLA-incompatible kidney transplantation: a nationwide cohort study. Transplant International, 30(12), 1215–1225. doi: 10.1111/tri.12979
Type
Article
ISSN
0934-0874
DOI
10.1111/tri.12979
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/41125
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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