Korean J Transplant.  2022 Nov;36(Supple 1):S384. 10.4285/ATW2022.F-5235.

A review of 50 kidney transplantation cases: the first steps of a small transplant center

• Lee H
• Son JY
• Ha MA
• Kang WJ
• Min JW

• KMID: 2535220
• DOI: http://doi.org/10.4285/ATW2022.F-5235

Abstract

The purpose of this study is to describe patient outcomes at a low-activity kidney transplantation (KT) center. We report a case series of the first 50 patients who underwent transplantation from 2016 to 2021 at a university hospital, low-activity KT center (≤35 KTs per year). Baseline patient characteristics and transplant outcomes such as rejection, graft failure, infection, and im-mediate postoperative complications were observed. Patient demographics showed a mean age of 44.9±11.1 years, 28 (58.3%) of patients were male and 23 (46%) of the transplants were from deceased donors. Five (10%) ABO-incompatible KTs were per-formed and seven (14%) patients were pre-sensitized with a high panel reactive antibody (PRA) of more than 50%. Thirty-two patients (64%) underwent basiliximab induction, and maintenance immunosuppression was done using tacrolimus in 49 (98%) recipients. Median post-KT follow-up duration 23.7 (interquartile range [IQR], 50.7) months. Of the 22 indication biopsies per-formed for elevated creatinine or proteinuria, four cases of T-cell mediated rejection (TCMR), two mixed rejection, seven calcineurin inhibitor (CNI) toxicities, and nine other (borderline, BK virus [BKV] nephropathy, recurrent glomerulonephritis, etc.) pathologies were observed. For immediate postoperative complications, there were two cases of postoperative hematoma and one case of lymphocele. For infectious complications, 12 cases of cytomegalovirus (CMV) viremia, two BKV nephropathy, one hepatitis B virus (HBV) reactivation, one neutropenic fever with invasive pulmonary aspergillosis, four urinary tract infections, and three COVID-19 pneumonias were observed. For other complications, two cases of avascular necrosis of the hip joint, two osteoporosis, one new-onset diabetes after transplant, two cataracts, and two recurrent glomerulonephritis cases were observed. One graft failure occurred 10 months post-KT due to delayed postoperative bleeding after restarting of antiplatelets. Although there is a selection bias of low-risk cases, the prognosis of KT patients at small, low-activity KT centers is favorable and KT should be offered to all eligible patients as the first and foremost option before dialysis.