대한신장학회

논문분류	춘계학술대회 초록집
제목	Risk Factors Affecting Clinical Outcome in Contemporary Kidney Transplantation; Single Center Experience
저자	Jae sung AHN1, *Kyung sun PARK2, Jongha PARK2, Hyun chul CHUNG2, Jong soo LEE2
출판정보	2017; 2017(1):
키워드	Kidney transplantation, clinical outcome, risk factor
초록	Objectives : In recent years, introduction of novel immunosuppressive agents (ISA) and its proper implementation for clinical practice have been contributed to improving clinical outcomes of kidney transplantation (KT). Here, we report clinical outcomes of KTs and risk factors affecting KT recipient outcomes Methods : From July 1998 to June 2016, 354 kidney transplantations (182 from living, 172 from deceased donors) have been performed at Ulsan university hospital. We retrospectively reviewed the clinical characteristics and outcomes of KT recipients. And Cox-regression analysis was used to identify the risk factors affecting long-term graft survival and patient survival. Results : The median follow-up period was 53 months. Mean age of recipients and donors are 45.0 and 44.7 years, respectively. Eleven patients have a history of previous KT failure. Median cold ischemia time of deceased donor KT was 307 minutes. Basiliximab and thymoglobulin were used for induction for 294 and 21 patients, respectively. Biopsy-proven acute rejection (BPAR) occurred to 70 patients (46 of acute cellular rejection, 16 of antibody-mediated rejection and 8 of undifferentiated). During follow-up, 13 grafts were lost and 5- and 10-year death-censored graft survival was 96.7% and 94.9% respectively. Cox-regression analysis showed that BPAR was a risk factor related to graft loss (HR 14.38, 95% CI 3.79-54.53, P <0.001). Nine patients died, and 5- and 10-year patient survival was 97.2% and 91.9%, respectively. Age >60 years (HR 6.03, 95% CI 1.12-32.61, P=0.037), diabetes (HR 6.18, 95% CI 1.35-28.22, P=0.019) and use of tacrolimus as initial ISA (HR 0.13 95% CI 0.03-0.56, P=0.007) were significantly related to patient survival. Conclusions : We experienced favoring clinical outcomes of KT in terms of graft failure and patient survival despite relatively higher proportion of KT from deceased donors. Further study might be needed to identify related factors, such as BPAR, age and diabetes identified from the present study, affecting promising KT outcomes of our cohort
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