근래의 신장이식 임상성적과 관련인자들: 단일기관 연구
= Clinical Outcomes and Contributors in Contemporary Kidney Transplantation: Single Center Experience
저자[authors] 안재성 ( Jae-sung Ahn ), 박경선 ( Kyung Sun Park ), 박종하 ( Jongha Park ), 정현철 ( Hyun Chul Chung ), 박호종 ( Hojong Park ), 박상준 ( Sang Jun Park ), 조홍래 ( Hong Rae Cho ), 이종수 ( Jong Soo Lee )
학술지명[periodical name] 大韓移植學會誌
권호사항[Volume/Issue] Vol.31No.4[2017]
발행처[publisher] 대한이식학회
자료유형[Document Type] 학술저널
수록면[Pagination] 182-192
언어[language] Korean
발행년[Publication Year] 2017
주제어[descriptor] Long-term outcomes, Kidney transplantation, Acute rejection, 장기간 성적, 신장이식, 급성 거부반응
초록[abstracts]
[Background: In recent years, introduction of novel immunosuppressive agents and its proper implementation for clinical practice have contributed to improving clinical outcomes of kidney transplantation (KT). Here, we report clinical outcomes of KTs and related risk factors. Methods: From July 1998 to June 2016, 354 KTs (182 from living and 172 from deceased donors) have been performed at Ulsan University Hospital. We retrospectively reviewed the clinical characteristics and outcomes of KT recipients, then estimated graft and patient survival rate were estimated and analyzed risk factors using Cox-regression. Results: The median follow-up period was 53 months (range; 3 to 220 months). The mean ages of recipients and donors were 45.0 years (SD, 12.5) and 44.7 years (SD, 13.6) years, respectively. During follow-up, 18 grafts were lost and 5- and 10-year death-censored graft survival was 96.7% and 91.5%, respectively. Biopsy-proven acute rejection (BPAR) occurred in 71 patients (55 cases of acute cellular rejection and 16 of antibody-mediated rejection). Cox-regression analysis showed that BPAR was a risk factor related to graft loss (hazard ratio [HR], 14.38; 95% confidence interval [CI], 3.79 to 54.53; P<0.001). In addition, 15 patients died, and the 5- and 10-year patient survival was 97.2% and 91.9%, respectively. Age ≥60 years (HR, 6.03; 95% CI, 1.12 to 32.61; P=0.037) and diabetes (HR, 6.18; 95% CI, 1.35 to 28.22; P=0.019) were significantly related to patient survival. Conclusions: We experienced excellent clinical outcomes of KT in terms of graft failure and patient survival despite the relatively high proportion of deceased donors. Long-term and short-term clinical outcomes have improved in the last two decades.]