Factors Affecting Mortality During Waiting Time for Kidney Transplantation: A Nationwide Population-Based Cohort Study Using the Korean Network for Organ Sharing (KONOS) Database.
1Seoul National University Hospital, Seoul, Republic of Korea
2Dongguk University Medical Center, Gyeongju, Republic of Korea
3Seoul National University Boramae Medical Center, Seoul, Republic of Korea.
Meeting: 2016 American Transplant Congress
Abstract number: C265
Keywords: Kidney transplantation, Mortality, Risk factors, Waiting lists
Session Information
Session Name: Poster Session C: Poster Session 1: Kidney Complications-Other
Session Type: Poster Session
Date: Monday, June 13, 2016
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Halls C&D
Background: Longer waiting times for kidney transplant have been suggested to be more deleterious than shorter waiting times. We analyzed the impact of waiting time on the post-transplant outcome and investigated risk factors for mortality during waiting time based on complete enumeration survey in Korea.
Patients and methods: We analyzed all persons over 18-years-old deceased donor kidney transplant cases enrolled in Korean Network for Organ Sharing (KONOS) data between Jan 2000 to Jan 2015. The primary end point was all cause of death after enrollment.
Results: Of the 24,296 waiting-listed dialysis subjects, 5,255 patients including 588 re-transplant cases received kidney transplantation from deceased donor with median waiting time of 4.5 years. Ten year overall survival was 81.3% in kidney transplant recipients, whereas 68.1% in dialysis patients. Unlike previously known data, the effect of waiting time on mortality after transplantation was insignificant. During waiting time, however, various demographic and clinical factors are associated with increased mortality. Diabetic patients are more likely to die before transplantation (HR 2.25, 95%CI 1.37-3.70, P=0.001). Aging is another significant risk factor for mortality. Only 56% of people aged 65 survive after 10 year of waiting, whereas 86% of people aged 35. Men are more likely to die than women during waiting time (HR 1.22, 1.13-1.31, P<0.001). Moreover, Patients with Rh negative blood type shows higher mortality rate than those with Rh positive (HR 1.60, 1.06-2.42, P=0.024). Pre-transplant experienced patients, however, showed better survival during waiting time (HR 0.63, 0.46-0.86, P=0.003).
Conclusion: Longer waiting times on dialysis do not affect survival after transplantation although transplant itself shows better overall survival. It should be emphasized to have more attention to the patients who are diabetic, old, men, or Rh negative with higher risk for mortality during waiting time.
CITATION INFORMATION: Lee S, Yoo K, An J, Oh Y, Lim C, Kim Y, Lee J. Factors Affecting Mortality During Waiting Time for Kidney Transplantation: A Nationwide Population-Based Cohort Study Using the Korean Network for Organ Sharing (KONOS) Database. Am J Transplant. 2016;16 (suppl 3).
To cite this abstract in AMA style:
Lee S, Yoo K, An J, Oh Y, Lim C, Kim Y, Lee J. Factors Affecting Mortality During Waiting Time for Kidney Transplantation: A Nationwide Population-Based Cohort Study Using the Korean Network for Organ Sharing (KONOS) Database. [abstract]. Am J Transplant. 2016; 16 (suppl 3). https://atcmeetingabstracts.com/abstract/factors-affecting-mortality-during-waiting-time-for-kidney-transplantation-a-nationwide-population-based-cohort-study-using-the-korean-network-for-organ-sharing-konos-database/. Accessed May 9, 2025.« Back to 2016 American Transplant Congress