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Synergistic impact of pre-sensitization and delayed graft function on allograft rejection in deceased donor kidney transplantation

Title
Synergistic impact of pre-sensitization and delayed graft function on allograft rejection in deceased donor kidney transplantation
Authors
Lee H.Park Y.Ban T.H.Song S.H.Yang J.Ahn C.Yang C.W.Chung B.H.Kong J.M.Kwon O.J.Kim D.G.Jung C.-W.Kim Y.H.Kim J.K.Kim C.-D.Min J.W.Park S.K.Park Y.H.Berm P.J.Park J.H.Park J.-W.Shin H.S.Yoon H.E.Lee K.W.Lee D.R.Lee D.W.Lee S.Y.Lee S.-H.Lee S.H.Lee J.J.Pyo L.J.Lee J.-H.Jeon J.S.Jun H.Jeong K.Chung K.Y.Cho H.R.Ki J.M.Chae D.-W.Choi S.J.N.Han D.J.Han S.Huh K.H.The Korean Organ Transplantation Registry Study Group
Ewha Authors
송승환
SCOPUS Author ID
송승환scopus
Issue Date
2021
Journal Title
Scientific Reports
ISSN
2045-2322JCR Link
Citation
Scientific Reports vol. 11, no. 1
Publisher
Nature Research
Indexed
SCIE; SCOPUS WOS scopus
Document Type
Article
Abstract
The aim of this study is to investigate whether or not delayed graft function (DGF) and pre-transplant sensitization have synergistic adverse effects on allograft outcome after deceased donor kidney transplantation (DDKT) using the Korean Organ Transplantation Registry (KOTRY) database, the nationwide prospective cohort. The study included 1359 cases between May 2014 and June 2019. The cases were divided into 4 subgroups according to pre-sensitization and the development of DGF post-transplant [non-pre-sensitized-DGF(−) (n = 1097), non-pre-sensitized-DGF(+) (n = 127), pre-sensitized-DGF(−) (n = 116), and pre-sensitized-DGF(+) (n = 19)]. We compared the incidence of biopsy-proven allograft rejection (BPAR), time-related change in allograft function, allograft or patient survival, and post-transplant complications across 4 subgroups. The incidence of acute antibody-mediated rejection (ABMR) was significantly higher in the pre-sensitized-DGF(+) subgroup than in other 3 subgroups. In addition, multivariable cox regression analysis demonstrated that pre-sensitization combined with DGF is an independent risk factor for the development of acute ABMR (hazard ratio 4.855, 95% confidence interval 1.499–15.727). Moreover, DGF and pre-sensitization showed significant interaction (p-value for interaction = 0.008). Pre-sensitization combined with DGF did not show significant impact on allograft function, and allograft or patient survival. In conclusion, the combination of pre-sensitization and DGF showed significant synergistic interaction on the development of allograft rejection after DDKT. © 2021, The Author(s).
DOI
10.1038/s41598-021-95327-6
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의료원 > 의료원 > Journal papers
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