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Synergistic impact of pre-sensitization and delayed graft function on allograft rejection in deceased donor kidney transplantation
- Source :
- Scientific Reports, Vol 11, Iss 1, Pp 1-11 (2021), Scientific Reports
- Publication Year :
- 2021
- Publisher :
- Nature Portfolio, 2021.
-
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.
- Subjects :
- Graft Rejection
Male
medicine.medical_specialty
Time Factors
Biopsy
Science
Urology
Delayed Graft Function
Kidney
Organ transplantation
Article
Medical research
Risk Factors
Medicine
Humans
Transplantation, Homologous
Prospective Studies
Risk factor
Prospective cohort study
Adverse effect
Proportional Hazards Models
Multidisciplinary
business.industry
Proportional hazards model
Incidence
Hazard ratio
Graft Survival
Middle Aged
Allografts
Kidney Transplantation
Confidence interval
Tissue Donors
Transplantation
surgical procedures, operative
Nephrology
Female
business
Subjects
Details
- Language :
- English
- ISSN :
- 20452322
- Volume :
- 11
- Issue :
- 1
- Database :
- OpenAIRE
- Journal :
- Scientific Reports
- Accession number :
- edsair.doi.dedup.....e914e1c0a3ddd08377c3b5260a73c1c9