PMID- 27512839
OWN - NLM
STAT- MEDLINE
DCOM- 20170209
LR  - 20240325
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Print)
IS  - 0025-7974 (Linking)
VI  - 95
IP  - 32
DP  - 2016 Aug
TI  - Analysis of 4000 kidney transplantations in a single center: Across immunological 
      barriers.
PG  - e4249
LID - 10.1097/MD.0000000000004249 [doi]
LID - e4249
AB  - Kidney transplant (KT) is the optimal renal replacement therapy for patients with 
      end-stage renal disease (ESRD). The demand for kidneys, however, continues to 
      exceed the supply. To overcome this problem, efforts to extend the donor pool by 
      including human leukocyte antigen (HLA)- and ABO-incompatible (ABOi) KTs are 
      increasing. The aim of this article was to retrospectively review data on 
      recipients, donor profiles, and clinical outcomes in 4000 cases of KT. In 
      addition, we analyzed clinical outcomes in ABOi and flow-cytometric crossmatch 
      (FCXM) positive KT in a subgroup analysis.This was a retrospective, observational 
      study using data extracted from medical records. A total of 4000 consecutive 
      patients who underwent KT at our institution from January 1990 to February 2015 
      were included in this study. KTs across immunological barriers such as ABO 
      incompatible (276 cases, 6.9%), FCXM positive (97 cases, 2.4%), and positive 
      complement-dependent cytotoxicity (CDC) XM KT (16 cases, 0.4%) were included.From 
      a Kaplan-Meier analysis, overall patient survival (PS) rates after KT at 1, 5, 
      10, and 20 years were 96.9%, 95.1%, 92.0%, and 88.9%, respectively. The overall 
      graft survival (GS) rates after KT at 1, 5, 10, and 20 years were 96.3%, 88.9%, 
      81.2%, and 67.4%, respectively. Our subgroup analysis suggested that overall PS, 
      GS, death-censored GS, and rejection-free GS in ABOi KT showed no significant 
      differences in comparison with ABO-compatible KT if adequate immunosuppressive 
      treatment was performed. The overall PS rate in patients who underwent FCXM 
      positive KT did not differ significantly from that of the control group during 
      the 3-year follow-up (P = 0.34). The overall GS, death-censored GS, and 
      rejection-free GS also did not differ significantly between the FCXM KT and 
      control groups (P = 0.99, 0.42, and 88).The outcomes of KTs continually improved 
      during the study period, while the annual number of KTs increased. ABO or FCXM 
      positive KTs can be performed safely with successful graft outcomes.
FAU - Kwon, Hyunwook
AU  - Kwon H
AD  - Department of Surgery, Hallym University Sacred Heart Hospital, Hallym University 
      College of Medicine, Pyeongchon Anyang Department of Surgery Division of 
      Nephrology, Department of Internal Medicine, Asan Medical Center, University of 
      Ulsan College of Medicine, Seoul, Korea.
FAU - Kim, Young Hoon
AU  - Kim YH
FAU - Choi, Ji Yoon
AU  - Choi JY
FAU - Sung, Shin
AU  - Sung S
FAU - Jung, Joo Hee
AU  - Jung JH
FAU - Park, Su-Kil
AU  - Park SK
FAU - Han, Duck Jong
AU  - Han DJ
LA  - eng
PT  - Journal Article
PT  - Observational Study
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
SB  - IM
MH  - Adult
MH  - Age Factors
MH  - Analysis of Variance
MH  - Databases, Factual
MH  - Graft Rejection
MH  - Graft Survival
MH  - Humans
MH  - Incidence
MH  - Kaplan-Meier Estimate
MH  - Kidney Failure, Chronic/mortality/*surgery
MH  - Kidney Transplantation/methods/*mortality/*statistics & numerical data
MH  - Living Donors
MH  - Male
MH  - Middle Aged
MH  - Prognosis
MH  - Retrospective Studies
MH  - Risk Assessment
MH  - Sex Factors
MH  - Statistics, Nonparametric
MH  - Survival Rate
MH  - *Tissue and Organ Procurement
MH  - Transplantation Immunology/*physiology
MH  - Treatment Outcome
PMC - PMC4985294
COIS- The authors have no funding and conflicts of interest to disclose.
EDAT- 2016/08/12 06:00
MHDA- 2017/02/10 06:00
PMCR- 2016/08/12
CRDT- 2016/08/12 06:00
PHST- 2016/08/12 06:00 [entrez]
PHST- 2016/08/12 06:00 [pubmed]
PHST- 2017/02/10 06:00 [medline]
PHST- 2016/08/12 00:00 [pmc-release]
AID - 00005792-201608090-00005 [pii]
AID - 10.1097/MD.0000000000004249 [doi]
PST - ppublish
SO  - Medicine (Baltimore). 2016 Aug;95(32):e4249. doi: 10.1097/MD.0000000000004249.