Korean J Transplant.  2023 Nov;37(Suppl 1):S208. 10.4285/ATW2023.F-7988.

Clinical outcomes in one-thousand deceased donor kidney transplantation: a single-center experience

• Jeong HM
• Min K
• Han M
• Kim H
• Kim O
• Lee S
• Lee S
• Kim J
• Woo HY
• Ha J

• KMID: 2551828
• DOI: http://doi.org/10.4285/ATW2023.F-7988

Abstract

Background
Recently, the clinical outcome of kidney transplantation (KT) has improved due to the development of effective immunosuppressive drug. At Seoul National University Hospital, after the first deceased donor KT (DDKT) in March 1988, it reached 1,000 cases in November 2022. The purpose of this study was to analyze the clinical results of DDKT in single center.
Methods
This is single center retrospective review of DDKTs from March 1988 to November 2022. Patients aged 19 years or older who underwent DDKT at Seoul National University Hospital in Korea were enrolled in this study.
Results
Mean age of recipients were 45.2±18.6 years and there were 595 males (59.6%). Mean waiting time for DDKT was 78.2 months. There were 133 zero human leukocyte antigen (HLA)-mismatch cases (13.3%), whose waiting time was significantly shorter than the average (non-zero HLA-mismatch vs. zero HLA-mismatch, 81.9±47.5 vs. 56.2±43.1 months; P<0.001). Of the overall recipients, 91 patients had previously received a transplant (9.1%). The most common cause of end-stage renal failure was glomerulonephritis (n=374, 37.4%), followed by diabetes (n=232, 23.2%). With a mean follow-up 113.6±79.1 months, overall 1-year, 3-year, 5-year, and 10-year death-censored graft survival were 98.2%, 97.6%, 97.5%, and 95.0% and overall 1-year, 3-year, 5-year, and 10-year patient survival were 98.2%, 97.6%, 97.1%, and 95.0%. The causes of mortality were pneumonia (n=22, 48.9%), cardiovascular disease (n=12, 26.7%), malignancy (n=4, 8.9%). Overall rejection rate was 2.2 % (n=22), of which T-cell mediated was 68.2 % (n=15).
Conclusions
The average waiting period for DDKT was approximately 6.5 years, and the rate of surgery earlier than the average waiting period with non-HLA-mismatches was 13.3%. The overall long-term graft survival rate was 95.0% at 10 years.