Risk Due to ABO Incompatibility and Donor-Recipient Weight Mismatch in Living Donor Kidney Transplantation: A National Cohort Study
- 주제(키워드) ABO incompatible , kidney transplantation , living donor , weight mismatch
- 주제(기타) Medicine, General & Internal
- 설명문(일반) [Lee, Jun Young; Kim, Deok Gie] Wonju Severance Christian Hosp, Transplantat Ctr, Wonju 26426, South Korea; [Lee, Jun Young] Yonsei Univ, Dept Nephrol, Wonju Coll Med, Wonju 26426, South Korea; [Cha, Sung Hwan; Kim, Deok Gie] Yonsei Univ, Dept Surg, Wonju Coll Med, Wonju 26426, South Korea; [Kim, Sung Hwa] Yonsei Univ, Dept Biostat, Wonju Coll Med, Wonju 26426, South Korea; [Jeong, Kyung Hwan] Kyung Hee Univ, Dept Internal Med, Coll Med, Seoul 02447, South Korea; [Chung, Ku Yong] Ewha Womans Univ, Dept Surg, Mokdong Hosp, Seoul 07985, South Korea; [Cho, Hong Rae] Ulsan Univ Hosp, Dept Surg, Ulsan 44030, South Korea; [Lee, Juhan; Huh, Kyu Ha; Kim, Myoung Soo] Yonsei Univ, Dept Surg, Coll Med, Seoul 03722, South Korea; [Yang, Jaeseok] Yonsei Univ, Dept Internal Med, Coll Med, Seoul 03722, South Korea
- 등재 SCIE, SCOPUS
- OA유형 Green Published, gold
- 발행기관 MDPI
- 발행년도 2021
- 총서유형 Journal
- URI http://www.dcollection.net/handler/ewha/000000190751
- 본문언어 영어
- Published As https://doi.org/10.3390/jcm10235674
- PubMed https://pubmed.ncbi.nlm.nih.gov/34884376
초록/요약
The effect of donor-recipient weight mismatch is not well established in ABO-incompatible living donor kidney transplantation (LDKT). A total of 2584 LDKT patients in the Korean Organ Transplantation Registry were classified into four groups according to the presence or absence of ABO incompatibility and donor-recipient weight mismatch (donor-to-recipient weight ratio (DRWR) < 0.8). In a multivariable Cox analysis, the combination of ABO incompatibility and DRWR incompatibility (n = 124) was an independent risk factor for graft survival (HR = 2.73, 95% CI = 1.11-6.70) and patient survival (HR = 3.55, 95% CI = 1.39-9.04), whereas neither factor alone was a significant risk factor for either outcome. The combination of ABO incompatibility and DRWR incompatibility was not an independent risk factor for biopsy-proven graft rejection (HR = 1.27, 95% CI = 0.88-1.82); however, it was an independent risk factor for pneumonia (HR = 2.94, 95% CI = 1.64-5.57). The mortality rate due to infection was higher among patients with both ABO incompatibility and DRWR incompatibility than among patients with neither factor or with either factor alone. The combination of ABO incompatibility and DRWR incompatibility was an independent risk factor for graft and patient survival after LDKT, whereas neither factor alone significantly affected graft or patient survival. Thus, donor-recipient weight matching should be cautiously considered in LDKT with ABO incompatibility.
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