Korean J Transplant.  2020 Sep;34(3):154-166. 10.4285/kjt.2020.34.3.154.

Clinical outcomes of the first 300 cases of kidney transplantation: a single-center retrospective cohort study

• Koh HW
• Koo K
• Shin CS
• Park HS
• Jeong JC
• Kim S
• Chae DW
• Oh JJ
• Byun SS
• Lee T

• KMID: 2507160
• DOI: http://doi.org/10.4285/kjt.2020.34.3.154

Abstract

Background
Kidney transplantation (KT) is regarded as the most effective treatment for end-stage renal disease. The annual number of KT cases in South Korea has increased rapidly as more centers are implementing a transplantation program. The objective of this study was to determine clinical outcomes of the first 300 consecutive cases of KT in a single center.
Methods
Clinical data of 300 cases of KT at Seoul National University Bundang Hospital from January 2004 to March 2018 were obtained from a prospectively collected database and retrospectively reviewed.
Results
The mean age of patients was 47.7±12.9 years, and 59% of patients were male. There were 225 living donors and 75 deceased donors. A total of 42 cases were from ABO-incompatible donors. During a mean follow-up of 68.6±43.5 months, 38 patients (12.7%) experienced rejection. The most common cause was acute T-cell mediated rejection (9.0%). Eighteen patients experienced graft loss. One-year and 5-year death-censored graft survival rates were 99% and 96.6%, respectively. One-year and 5-year patient survival rates were 98.3% and 96.6%, respectively. Multivariate analysis revealed that graft weight-to-recipient weight ratio and rejection were significant factors affecting graft survival.
Conclusions
This single-center review demonstrates clinical outcomes comparable to other major centers. Such good outcomes were obtained by good patient selection, dedicated transplant physicians, and adequate use of immunosuppressive therapy.

Keyword

Transplantation; Kidney transplantation

Figure

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  Fig. 1 Statistics. (A) Annual number of kidney transplantations in Seoul National University Bundang Hospital. (B) Number of centers performing kidney transplantation in South Korea. Circle, total number of centers performing kidney transplantation; triangle, large-volume centers performing more than 50 cases annually; diagonal, small centers performing 50 cases or less annually.

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  Fig. 2 Graft survival and patient survival after kidney transplantation. (A) Death-censored graft survival and (B) survival in 300 cases of kidney transplantation. (C) Death-censored graft survival and (D) patient survival of living donors and deceased donors. (E) Death-censored graft survival and (F) patient survival of living related donors and living unrelated donors. (G) Death-censored graft survival and (H) patient survival of ABO-compatible pairs and ABO-incompatible pairs. LD, living donor; DD, deceased donor; LRD, living related donor; LUD, living unrelated donor; ABOc, ABO-compatible; ABOi, ABO-incompatible.

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