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Kidney transplantation after desensitization in sensitized patients: a Korean National Audit.
DC Field | Value | Language |
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dc.contributor.author | 김범석 | - |
dc.contributor.author | 허규하 | - |
dc.date.accessioned | 2014-12-19T16:59:02Z | - |
dc.date.available | 2014-12-19T16:59:02Z | - |
dc.date.issued | 2012 | - |
dc.identifier.issn | 0301-1623 | - |
dc.identifier.uri | https://ir.ymlib.yonsei.ac.kr/handle/22282913/90561 | - |
dc.description.abstract | INTRODUCTION: The number of end-stage renal disease (ESRD) patients with preformed antibodies waiting for a kidney transplant has been increasing lately. We conducted a nationwide study on the outcomes of kidney transplantation after desensitization in Korea. METHODS: Six transplant centers have run desensitization programs. The patients who underwent living donor kidney transplantation after desensitization from 2002 to 2010 were retrospectively analyzed. RESULTS: A total of 86 cases were enrolled. Thirty-five of these were cases of re-transplantation (40.7 %). Indications of desensitization were positive complement-dependent cytotoxicity (CDC) cross-match responses (CDC(+), 36.0 %), positive flow-cytometric cross-match responses (FCX(+), 54.7 %), and positive donor-specific antibodies (DSA(+), 8.1 %). The desensitization protocols used pre-transplant plasmapheresis (95.3 %), intravenous immunoglobulin (62.8 %), and rituximab (67.4 %). Acute rejection occurred in 18 patients (20.9 %), graft failure occurred in 4 patients, and the 3-year graft survival rate was 93.8 %. The presence of DSA increased the acute rejection rate (P = 0.015) and decreased the 1-year post-transplant estimated glomerular filtration rate (P = 0.006). Although rejection-free survival rates did not differ significantly between the CDC(+) and FCX(+) groups, the 1-year estimated glomerular filtration rate was lower in the CDC(+) group (P = 0.010). Infectious and significant bleeding complications occurred in 15.5 % and 4.7 % of cases, respectively. CONCLUSION: Kidney transplantation after desensitization had good graft outcomes and tolerable complications in Korea, and therefore, this therapy can be recommended for sensitized ESRD patients. | - |
dc.description.statementOfResponsibility | open | - |
dc.relation.isPartOf | INTERNATIONAL UROLOGY AND NEPHROLOGY | - |
dc.rights | CC BY-NC-ND 2.0 KR | - |
dc.rights.uri | https://creativecommons.org/licenses/by-nc-nd/2.0/kr/ | - |
dc.subject.MESH | Adult | - |
dc.subject.MESH | Antibodies/blood | - |
dc.subject.MESH | Antibodies, Monoclonal, Murine-Derived/administration & dosage | - |
dc.subject.MESH | Desensitization, Immunologic*/methods | - |
dc.subject.MESH | Disease-Free Survival | - |
dc.subject.MESH | Female | - |
dc.subject.MESH | Glomerular Filtration Rate/immunology | - |
dc.subject.MESH | Graft Rejection/immunology* | - |
dc.subject.MESH | Graft Survival* | - |
dc.subject.MESH | Histocompatibility* | - |
dc.subject.MESH | Humans | - |
dc.subject.MESH | Immunoglobulins, Intravenous/administration & dosage | - |
dc.subject.MESH | Immunologic Factors/administration & dosage | - |
dc.subject.MESH | Kaplan-Meier Estimate | - |
dc.subject.MESH | Kidney Failure, Chronic/surgery | - |
dc.subject.MESH | Kidney Transplantation/immunology* | - |
dc.subject.MESH | Kidney Transplantation/physiology | - |
dc.subject.MESH | Male | - |
dc.subject.MESH | Middle Aged | - |
dc.subject.MESH | Plasmapheresis | - |
dc.subject.MESH | Republic of Korea | - |
dc.subject.MESH | Retrospective Studies | - |
dc.subject.MESH | Rituximab | - |
dc.title | Kidney transplantation after desensitization in sensitized patients: a Korean National Audit. | - |
dc.type | Article | - |
dc.contributor.college | College of Medicine (의과대학) | - |
dc.contributor.department | Dept. of Internal Medicine (내과학) | - |
dc.contributor.googleauthor | Kyu Ha Huh | - |
dc.contributor.googleauthor | Beom Seok Kim | - |
dc.contributor.googleauthor | Jaeseok Yang | - |
dc.contributor.googleauthor | Jeongmyung Ahn | - |
dc.contributor.googleauthor | Myung-Gyu Kim | - |
dc.contributor.googleauthor | Jae Berm Park | - |
dc.contributor.googleauthor | Jong Man Kim | - |
dc.contributor.googleauthor | Byung-Ha Chung | - |
dc.contributor.googleauthor | Joong Kyung Kim | - |
dc.contributor.googleauthor | Jin Min Kong | - |
dc.identifier.doi | 22528582 | - |
dc.admin.author | false | - |
dc.admin.mapping | false | - |
dc.contributor.localId | A00488 | - |
dc.contributor.localId | A04344 | - |
dc.relation.journalcode | J01177 | - |
dc.identifier.eissn | 1573-2584 | - |
dc.identifier.pmid | 22528582 | - |
dc.identifier.url | http://link.springer.com/article/10.1007%2Fs11255-012-0169-1 | - |
dc.subject.keyword | Immunologic desensitization | - |
dc.subject.keyword | Kidney transplantation | - |
dc.subject.keyword | Rejection | - |
dc.contributor.alternativeName | Kim, Beom Seok | - |
dc.contributor.alternativeName | Huh, Kyu Ha | - |
dc.contributor.affiliatedAuthor | Kim, Beom Seok | - |
dc.contributor.affiliatedAuthor | Huh, Kyu Ha | - |
dc.citation.volume | 44 | - |
dc.citation.number | 5 | - |
dc.citation.startPage | 1549 | - |
dc.citation.endPage | 1557 | - |
dc.identifier.bibliographicCitation | INTERNATIONAL UROLOGY AND NEPHROLOGY, Vol.44(5) : 1549-1557, 2012 | - |
dc.identifier.rimsid | 32834 | - |
dc.type.rims | ART | - |
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