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Impact of delayed graft function on clinical outcomes in highly sensitized patients after deceased-donor kidney transplantation

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Author(s)
Seong Gyu KimSuyeon HongHanbi LeeSang Hun EumYoung Soo KimKyubok JinSeungyeop HanChul Woo YangWoo Yeong ParkByung Ha Chung
Keimyung Author(s)
Jin, Kyu BokHan, Seung YeupPark, Woo Young
Department
Dept. of Internal Medicine (내과학)
Journal Title
Korean J Transplant
Issued Date
2021
Volume
35
Issue
3
Keyword
Kidney transplantationDelayed graft functionSensitizationGraft lossAcute rejection
Abstract
Background:
We investigated whether the development of delayed graft function (DGF) in pre-sensitized patients affects the clinical outcomes after deceased-donor kidney transplantation (DDKT).

Methods:
The study included 709 kidney transplant recipients (KTRs) from three transplant centers. We divided KTRs into four subgroups (highly sensitized DGF, highly sensitized non-DGF, low-sensitized DGF, and low-sensitized non-DGF) according to panel reactive antibody level of 50%, or DGF development. We compared post-transplant clinical outcomes among the four subgroups.

Results:
Incidence of biopsy-proven acute rejection (BPAR) was higher in two highly sensitized subgroups than in low-sensitized subgroups. It tended to be higher in highly sensitized DGF subgroups than in the highly sensitized non-DGF subgroups. In addition, the highly sensitized DGF subgroup showed the highest risk for BPAR (hazard ratio, 3.051; P=0.005) and independently predicted BPAR. Allograft function was lower in the two DGF subgroups than in the non-DGF subgroup until one month after transplantation, but thereafter it was similar. Death-censored graft loss rates and patient mortality tended to be low when DGF developed, but it did not reach statistical significance.

Conclusions:
DGF development in highly sensitized patients increases the risk for BPAR in DDKT compared with patients without DGF, suggesting the need for strict monitoring and management of such cases.
Keimyung Author(s)(Kor)
진규복
한승엽
박우영
Publisher
School of Medicine (의과대학)
Citation
Seong Gyu Kim et al. (2021). Impact of delayed graft function on clinical outcomes in highly sensitized patients after deceased-donor kidney transplantation. Korean J Transplant, 35(3), 149–160. doi: 10.4285/kjt.21.0014
Type
Article
ISSN
2671-8804
Source
https://www.ekjt.org/journal/view.html?uid=1260&vmd=Full
DOI
10.4285/kjt.21.0014
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/43769
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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