Initial Report of the Korean Organ Transplant Registry: The First Report of National Kidney Transplantation Data

Geriatrics Gerontology Int

Ahn

et al. 2019

Aim The aim of the present study was to investigate the clinical outcomes of kidney transplantation (KT) in elderly recipients compared with those in young recipients. Methods We compared the incidence of biopsy‐proven acute rejection, death‐censored allograft survival and all‐cause mortality, and also compared the impact of high sensitization or desensitization on the clinical outcomes of elderly and young recipients. Results A total of 4966 KT recipients from the Korean Organ Transplantation Registry were included. The definition of elderly recipients was based on age >60 years (n = 356), and recipients aged <60 years were defined as young recipients (n = 4610). The incidence of biopsy‐proven acute rejection did not differ between the two groups irrespective of the donor type; however, the impact of high sensitization was significant only in young recipients. Being an elderly recipient was an independent risk factor for death‐censored allograft failure in terms of overall and living donor KT, but not with deceased donor KT. In regard to patient death, being an elderly recipient was a significant predictor in general and in the two subgroups, and desensitization showed a significant interaction with death in the elderly recipients in the living donor KT group. Conclusions In conclusion, KT in elderly recipients might be associated with poor allograft or patient survival in general, and especially, desensitization therapy carried out in these patients might increase the risk of patient mortality. Geriatr Gerontol Int 2019; 19: 392–398.

Section: Methodsmentioning

confidence: 99%

“…We analyzed the Korea Organ Transplantation Registry data from the Korean Society for Transplantation. 9 The LDKT or DDKT groups were classified into elderly-LDKT (n = 190) or young-LDKT (n = 2853) and also into elderly-DDKT (n = 166) or young-DDKT (n = 1757) based on their age and donor type ( Fig. S1).…”

Section: Study Populationmentioning

confidence: 99%

Clinical outcomes of kidney transplantation in older end‐stage renal disease patients: A nationwide cohort study

Geriatrics Gerontology Int

Ahn

et al. 2019

“…To compare the clinical outcomes of ABOi and HLAi KT, we analysed KOTRY data from the Korean Society for Transplantation . Compiling data from 46 kidney transplantation centres, the KOTRY database contained a total of 4987 cases from conducted between 2009 and 2012, accounting for 92.1% of all KTs performed in Korea during this period.…”

Section: Methodsmentioning

confidence: 99%

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

et al. 2017

Transpl Int

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.

“…5 Among these cases, we used data from 2003 to 2014 (the period for which donor information was fully satisfied). The second database was the Korean Organ Transplantation Registry established by the Korean Society for Transplantation [6, 7], to evaluate clinical outcomes of ABOi-KT from spousal donors. A total of 4,987 cases from 46 KT centers between 2009 and 2012 were included, which comprised 92.1% of the KTs in Korea during this period.…”

Section: Methodsmentioning

confidence: 99%

Impact of ABO incompatible kidney transplantation on living donor transplantation

Chung

2017

PLoS ONE

BackgroundABO incompatible kidney transplantation (ABOi-KT) is an important approach for overcoming donor shortages. We evaluated the effect of ABOi-KT on living donor KT.MethodsTwo nationwide transplantation databases were used. We evaluated the impact of ABOi-KT on overall living donor transplant activity and spousal donation as subgroup analysis. In addition, we compared the clinical outcome between ABOi-KT and ABO compatible KT (ABOc-KT) from spousal donor, and performed a Cox proportional hazards regression analysis to define the risk factors affecting the allograft outcomes.ResultThe introduction of ABOi-KT increased overall living donor KT by 12.2% and its portion was increased from 0.3% to 21.7% during study period. The ABOi-KT in living unrelated KT was two times higher than that of living related donor KT (17.8 vs.9.8%). Spousal donor was a major portion of living unrelated KT (77.6%) and ABOi-KT increased spousal donation from 10% to 31.5% in living donor KT. In addition, increasing rate ABOi-KT from spousal donor was 10 times higher than that of living related donor. The clinical outcome (incidence of acute rejection, allograft function, and allograft and patient survival rates) of ABOi-KT from spousal donor was comparable to that of ABOc-KT. Neither ABO incompatibility nor spousal donor was associated with acute rejection or allograft failure on multivariate analysis.ConclusionsABOi-KT increased overall living donor KT, and ABOi-KT from spousal donor is rapidly increasing with favorable clinical outcomes.