Effect of pretransplant dialysis vintage on clinical outcomes in deceased donor kidney transplant

Author:

Lim Jeong-Hoon,Jeon Yena,Kim Deok Gie,Kim Yeong Hoon,Kim Joong Kyung,Yang Jaeseok,Kim Myoung Soo,Jung Hee-Yeon,Choi Ji-Young,Park Sun-Hee,Kim Chan-Duck,Kim Yong-Lim,Cho Jang-Hee,Kim Myoung Soo,Yang Jaeseok,Kong Jin Min,Kwon Oh Jung,Kim Deok Gie,Jung Cheol Woong,Kim Yeong Hoon,Kim Joong Kyung,Kim Chan-Duck,Min Ji Won,Lee Sik,Park Yeon Ho,Park Jae Berm,Park Jung Hwan,Park Jong-Won,Ban Tae Hyun,Song Sang Heon,Song Seung Hwan,Shin Ho Sik,Yang Chul Woo,Yoon Hye Eun,Lee Kang Wook,Lee Sang-Ho,Lee Su Hyung,Lee Yu Ho,Lee Jung Pyo,Lee Jeong-Hoon,Jeon Jin Seok,Jun Heungman,Jeong Kyung Hwan,Chung Ku Yong,Lee Jong Soo,Chae Dong-Wan,Choi Soo Jin Na,Shin Sung,Han Seungyeup,Huh Kyu Ha,

Abstract

AbstractThe waiting time for deceased donor kidney transplants (DDKT) is increasing. We evaluated DDKT prognosis according to the pretransplant dialysis vintage. A total of 4117 first-time kidney transplant recipients were enrolled from a prospective nationwide cohort in Korea. DDKT recipients were divided into tertiles according to pretransplant dialysis duration. Graft failure, mortality, and composite were compared between DDKT and living donor kidney transplant (LDKT) recipients. Pretransplant dialysis vintage was longer annually in DDKT recipients. In the subdistribution of the hazard model for the competing risk, the first tertile did not show an increased risk of graft failure compared with LDKT recipients; however, the second and third tertile groups had an increased risk of graft failure compared to LDKT recipients (adjusted hazard ratio [aHR] 3.59; 95% confidence interval [CI] 1.69–7.63; P < 0.001; aHR 2.37; 95% CI 1.06–5.33; P = 0.037). All DDKT groups showed a significantly higher risk of patient death than LDKT, with the highest risk in the third tertile group (aHR 11.12; 95% CI 4.94–25.00; P < 0.001). A longer pretransplant dialysis period was associated with a higher risk of the composite of patient death and graft failure in DDKT recipients. DDKT after a short period of dialysis had non-inferior results on graft survival compared with LDKT.

Funder

National Research Foundation of Korea

Korea Centers for Disease Control and Prevention

Publisher

Springer Science and Business Media LLC

Subject

Multidisciplinary

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