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

  • 주제(키워드) desensitization , elderly , kidney transplantation , patient mortality , sensitization
  • 주제(기타) Geriatrics & Gerontology; Gerontology
  • 설명문(일반) [Ko, Eun Jeong; Yang, Chul Woo; Chung, Byung Ha] Catholic Univ Korea, Transplantat Res Ctr, Seoul St Marys Hosp, Div Nephrol,Dept Internal Med,Coll Med, Seoul, South Korea; [Yang, Jaeseok; Ahn, Curie] Seoul Natl Univ Hosp, Dept Transplantat Ctr, Jongno, South Korea; [Ahn, Curie] Seoul Natl Univ Hosp, Dept Internal Med Nephrol, Jongno, South Korea; [Kim, Myoung Soo] Severance Hosp, Dept Surg Transplantat, Seodaemun, South Korea; [Han, Duck Jong] Univ Ulsan, Coll Med, Asan Med Ctr, Dept Surg Transplantat, Songpa, South Korea; [Kim, Sung Joo] Samsung Med Ctr, Dept Surg Transplantat, Gangnam, South Korea; [Ahn, Curie; Chae, Dong Wan; Yang, Jaeseok] Seoul Natl Univ Hosp, Transplantat Ctr, Seoul, South Korea; [Choi, Bum Soon] Catholic Univ Korea, Dept Internal Med, Seoul, South Korea; [Jung, Cheol Woong] Korea Univ, Anam Hosp, Dept Surg, Seoul, South Korea; [Kim, Myoung Soo] Yonsei Univ, Coll Med, Severance Hosp, Dept Surg, Seoul, South Korea; [Kwon, Oh Jung] Hanyang Univ Hosp, Dept Surg, Seoul, South Korea; [Kim, Sung-Joo] Sungkyunkwan Univ, Sch Med, Samsung Med Ctr, Dept Surg, Seoul, South Korea; [Kim, Yeong Hoon] Inje Univ, Coll Med, Busan Paik Hosp, Organ Transplantat Ctr, Gimhae, South Korea; [Choi, SooJinNa] Chonnam Natl Univ, Dept Surg, Gwangju, South Korea; [Han, Seung Yeup] Keimyung Univ, Sch Med, Dept Internal Med, Daegu, South Korea; [Han, Duck Jong] Ulsan Med Ctr, Dept Surg, Ulsan, South Korea; [Han, Duck Jong] Univ Ulsan, Coll Med, Ulsan, South Korea; [Lee, Sang Ho; Jeong, Kyung Hwan] Kyung Hee Univ, Coll Med, Dept Internal Med, Seoul, South Korea; [Kim, Seung Jung] Ewha Womans Univ, Med Ctr, Dept Internal Med, Seoul, South Korea; [Jeon, Jin Seok] Soon Chun Hyang Univ Hosp, Dept Internal Med, Seoul, South Korea; [Park, Yeon Ho] Gachon Univ, Gil Med Ctr, Dept Surg, Seongnam, South Korea; [Roh, Young Nam] Inje Univ, Ilsan Paik Hosp, Organ Transplantat Ctr, Gimhae, South Korea; [Lee, Jeong Joon] CHA Univ, CHA Bundang Med Ctr, Pochon, South Korea; [Lee, Kang Wook] Chungnam Natl Univ, Dept Internal Med, Daejeon, South Korea; [Han, Seung Yeup] Keimyung Univ, Dongsan Med Ctr, Dept Internal Med, Daegu, South Africa; [Kim, Chan Duck] Kyungpook Natl Univ Hosp, Dept Internal Med, Daegu, South Africa; [Park, Jong Won] Yeungnam Univ Hosp, Dept Internal Med, Daegu, South Africa; [Kim, Joong Kyung] Bong Seng Mem Hosp, Dept Internal Med, Busan, South Korea; [Lee, Dong Ryeol] Maryknoll Med Ctr, Dept Internal Med, Busan, South Korea; [Lee, Dong Won; Seong, Eun Young] Pusan Natl Univ Hosp, Dept Internal Med, Pusan, South Korea; [Kong, Jin Min] BHS Han Seo Hosp, Dept Internal Med, Busan, South Korea; [Cho, Hong Rae] Ulsan Univ Hosp, Dept Surg, Ulsan, South Korea; [Park, Sung Kwang] Chonbuk Natl Univ Hosp, Dept Internal Med, Jeonju, South Korea; [Lee, Sam Yeol] Hallym Univ, Med Ctr, Chunchon, South Korea; [Park, Jung Hwan] Konkuk Univ, Med Ctr, Dept Internal Med, Seoul, South Korea
  • 등재 SCIE, SSCI, SCOPUS
  • 발행기관 WILEY
  • 발행년도 2019
  • URI http://www.dcollection.net/handler/ewha/000000159929
  • 본문언어 영어
  • Published As http://dx.doi.org/10.1111/ggi.13630
  • PubMed https://pubmed.ncbi.nlm.nih.gov/30788912

초록/요약

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.

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