Date: Monday, June 3, 2019
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Hall C & D
*Purpose: Despite the graft outcome has been steadily improved over the years, early graft failure (EGF) poses a significant threat to kidney transplant (KT) recipients. Our objective was to investigate the clinical outcomes in patients with EGF.
*Methods: We analyzed a Nationwide Health Insurance Database of South Korea and identified patients who received KT from the year of 2006 to 2014. Among 10,822 KT recipients, we assessed the incidence of depression, dementia, Alzheimer’s disease, vascular dementia, malignancy, stroke, myocardial infarction (MI), and all-cause mortality after KT. EGF was defined as irreversible loss of graft function requiring renal replacement therapy within a year after KT.
*Results: During the study periods, there were 847 incident depression cases, 483 malignancies, 174 cases of stroke, 140 cases of MI, and 283 all-cause death. The crude incidence rate (IR) for depression was significantly higher among patients with EGF (23.0 / 1000 person years [PY]) compared with those without EGF (16.8 / 1000 person years). Comparable findings were observed for incident cases of malignancy (IR: EGF, 7.6 versus no EGF, 9.5), stroke (2.7 vs 3.8), MI (2.0 vs 3.5), and all-cause death (3.7 vs 7.8). After full adjustment, patients with EGF were at higher risk of depression (HR 1.33; 95% CI 1.15, 1.53) whereas no significant relationships were found for other psychiatric disorders such as dementia, Alzheimer’s disease or vascular dementia. KT recipients with EGF tended to be at increased risk of malignancy compared with those without graft failure (hazard ratio [HR], 1.23; 95% CI: 1.02, 1.49). EGF was significantly associated with stroke (HR 1.38; 95% CI 1.02, 1.89) and myocardial infarction (HR 1.69; 95% CI 1.21, 2.36) and also with all-cause mortality (HR 2.03; 95% CI 1.61, 2.48).
*Conclusions: EGF was associated with poor clinical outcomes in KT recipients. The risk of malignancy, depression, stroke/MI, and all-cause mortality were increased in patients with EGF. Although there is a poor outcome in EGF, further study is warranted on the potential benefit compared with patients not having KT at all.
To cite this abstract in AMA style:Kim Y, Kwon S, Park S, Moon J, Seon J, Kim J, Yu M, Han K, Kim D, Kim Y, Lee H. The Clinical Outcomes of Kidney Transplant Recipients with Early Graft Failure: A Nationwide Study in South Korea [abstract]. Am J Transplant. 2019; 19 (suppl 3). https://atcmeetingabstracts.com/abstract/the-clinical-outcomes-of-kidney-transplant-recipients-with-early-graft-failure-a-nationwide-study-in-south-korea/. Accessed April 16, 2021.
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