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Characteristics of kidney transplantation recipients over time in South Korea

Korean Journal of Internal Medicine 2020년 35권 6호 p.1457 ~ 1467
박세훈, 김명숙, 김지은, 김광수, 박민수, 김용철, 주권욱, 김연수, 이하정,
소속 상세정보
박세훈 ( Park Se-Hoon ) - Armed Forces Capital Hospital Department of Internal Medicine
김명숙 ( Kim Myoung-Suk ) - Seoul National University Hospital Department of Biomedical Research
김지은 ( Kim Ji-Eun ) - Seoul National University Hospital Department of Internal Medicine
김광수 ( Kim Kwang-Soo ) - Seoul National University Hospital Department of Biomedical Research
박민수 ( Park Min-Su ) - Samsung Medical Center Samsung Biomedical Research Institute Statistics and Data Center
김용철 ( Kim Yong-Chul ) - Seoul National University Hospital Department of Internal Medicine
주권욱 ( Joo Kwon-Wook ) - Seoul National University Hospital Department of Internal Medicine
김연수 ( Kim Yon-Su ) - Seoul National University Hospital Department of Internal Medicine
이하정 ( Lee Ha-Jeong ) - Seoul National University Hospital Department of Internal Medicine

Abstract


Background/Aims: Detailed nationwide information regarding the recent status and time trends of kidney transplantation (KT) in South Korea is limited.

Methods: We performed a nationwide, population-based cohort study using the national claims database of Korea. We included KT recipients from 2008 to 2016, and their demographic and clinical characteristics were collected. The prognostic outcome was graft failure consisted of patient death and death-censored graft failure (DCGF).

Results: We studied 14,601 KT recipients with median follow-up duration of 3.96 years. The median age at the time of transplantation consistently increased from the past, and proportion of underlying diabetes mellitus prominently increased, reaching 35.6% in 2016. The preemptive KT accounted for approximately 30% of the total transplantation cases. The recipients showed a 10-year cumulative graft survival rate of 71.8%, consisting of 10-year DCGF free survival of 77.6% and patient survival of 92.8%. Age ≥ 20 and < 30 years, age ≥ 70 years, underlying history of diabetes, non-preemptive transplantation, and poor compliance on tacrolimus and mycophenolic acid were the significant risk factors associated with worse DCGF outcome. The economic cost of KT showed prominently increasing trends, reaching a total insured fee of > 60,000,000$ in 2016. However, the expansion was mainly burdened by the national insurance service but not by the patients.

Conclusions: In South Korea, the number of kidney transplantation in elderly or in patients with comorbidities has been increasing. Complex clinical factors were associated with medication compliance and patient prognosis.

키워드

Kidney transplantation; Graft survival; Epidemiology

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