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Risk Due to ABO Incompatibility and Donor-Recipient Weight Mismatch in Living Donor Kidney Transplantation: A National Cohort Study

Authors
 Jun Young Lee  ;  Sung Hwan Cha  ;  Sung Hwa Kim  ;  Kyung Hwan Jeong  ;  Ku Yong Chung  ;  Hong Rae Cho  ;  Juhan Lee  ;  Kyu Ha Huh  ;  Jaeseok Yang  ;  Myoung Soo Kim  ;  Deok Gie Kim 
Citation
 JOURNAL OF CLINICAL MEDICINE, Vol.10(23) : 5674, 2021-12 
Journal Title
JOURNAL OF CLINICAL MEDICINE
Issue Date
2021-12
Keywords
ABO incompatible ; kidney transplantation ; living donor ; weight mismatch
Abstract
The effect of donor-recipient weight mismatch is not well established in ABO-incompatible living donor kidney transplantation (LDKT). A total of 2584 LDKT patients in the Korean Organ Transplantation Registry were classified into four groups according to the presence or absence of ABO incompatibility and donor-recipient weight mismatch (donor-to-recipient weight ratio (DRWR) < 0.8). In a multivariable Cox analysis, the combination of ABO incompatibility and DRWR incompatibility (n = 124) was an independent risk factor for graft survival (HR = 2.73, 95% CI = 1.11-6.70) and patient survival (HR = 3.55, 95% CI = 1.39-9.04), whereas neither factor alone was a significant risk factor for either outcome. The combination of ABO incompatibility and DRWR incompatibility was not an independent risk factor for biopsy-proven graft rejection (HR = 1.27, 95% CI = 0.88-1.82); however, it was an independent risk factor for pneumonia (HR = 2.94, 95% CI = 1.64-5.57). The mortality rate due to infection was higher among patients with both ABO incompatibility and DRWR incompatibility than among patients with neither factor or with either factor alone. The combination of ABO incompatibility and DRWR incompatibility was an independent risk factor for graft and patient survival after LDKT, whereas neither factor alone significantly affected graft or patient survival. Thus, donor-recipient weight matching should be cautiously considered in LDKT with ABO incompatibility.
Files in This Item:
T202124635.pdf Download
DOI
10.3390/jcm10235674
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Myoung Soo(김명수) ORCID logo https://orcid.org/0000-0002-8975-8381
Yang, Jaeseok(양재석)
Lee, Ju Han(이주한)
Huh, Kyu Ha(허규하) ORCID logo https://orcid.org/0000-0003-1364-6989
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/187489
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