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Serum creatinine level at 1-month posttransplant can independently predict long-term graft survival and functional status

대한이식학회지 2020년 34권 4호 p.244 ~ 248
고성민, 주만기, 허규하, 김유선, 김명수,
소속 상세정보
고성민 ( Koh Sung-Min ) - Yonsei University College of Medicine Department of Surgery
주만기 ( Ju Man-Ki ) - Yonsei University College of Medicine Department of Surgery
허규하 ( Huh Kyu-Ha ) - Yonsei University College of Medicine Department of Surgery
김유선 ( Kim Yu-Suen ) - Yonsei University College of Medicine Department of Surgery
김명수 ( Kim Myoung-Soo ) - Yonsei University College of Medicine Department of Surgery

Abstract


Background: After the year 2000, kidney transplants with high immunologic risk and deceased donors increased rapidly in Korea. At the same time, the medical community developed special pretransplant and early posttransplantation management protocols. Our team evaluated the effect of early graft stabilization on long-term graft survival and functional status using databases from a high-volume kidney transplantation center.

Methods: We included 1,895 kidney transplant patients from a total of 1,976 performed between 2005 and 2018. Early graft failure within 1 month (n=9), loss to follow-up (n=2), pediatric recipient or donor (n=37), and combined organ transplantation (n=33) cases were excluded. We grouped the cases at 1-month posttransplantation by serum creatinine quantiles (1.0 mg%, 1.23 mg%, and 1.52 mg%).

Results: After an average of 95 months of follow-up (maximum 189 months), the high-serum creatinine group (4th quantile) showed significantly poorer graft survival than other groups (1st to 3rd quantile) (P<0.05). In multiple Cox regression analysis, a high serum creatinine level (4th quantile) at 1-month posttransplant is an independent risk factor for graft failure with a hazard ratio of 1.799 (P=0.013). The quantile group by serum creatinine shows a persistent, significant difference of functional graft status (glomerular filtration rate by Modification of Diet in Renal Disease method) among quantile groups beyond ten years posttransplant.

Conclusions: Serum creatinine level at 1-month posttransplant is a strong independent predictor of graft survival and functional graft status beyond ten years posttransplant.

키워드

Creatinine; Kidney transplant; Graft survival

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