Synergistic impact of pre-sensitization and delayed graft function on allograft rejection in deceased donor kidney transplantation

Abstract The aim of this study is to investigate whether or not delayed graft function (DGF) and pre-transplant sensitization have synergistic adverse effects on allograft outcome after deceased donor kidney transplantation (DDKT) using the Korean Organ Transplantation Registry (KOTRY) database, the...

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Autores principales:	Hanbi Lee, Yohan Park, Tae Hyun Ban, Sang Heon Song, Seung Hwan Song, Jaeseok Yang, Curie Ahn, Chul Woo Yang, Byung Ha Chung, The Korean Organ Transplantation Registry Study Group
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/2afe8166e69b4754a74ea60fc4d86177
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spelling	oai:doaj.org-article:2afe8166e69b4754a74ea60fc4d861772021-12-02T19:06:33ZSynergistic impact of pre-sensitization and delayed graft function on allograft rejection in deceased donor kidney transplantation10.1038/s41598-021-95327-62045-2322https://doaj.org/article/2afe8166e69b4754a74ea60fc4d861772021-08-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-95327-6https://doaj.org/toc/2045-2322Abstract The aim of this study is to investigate whether or not delayed graft function (DGF) and pre-transplant sensitization have synergistic adverse effects on allograft outcome after deceased donor kidney transplantation (DDKT) using the Korean Organ Transplantation Registry (KOTRY) database, the nationwide prospective cohort. The study included 1359 cases between May 2014 and June 2019. The cases were divided into 4 subgroups according to pre-sensitization and the development of DGF post-transplant [non-pre-sensitized-DGF(−) (n = 1097), non-pre-sensitized-DGF(+) (n = 127), pre-sensitized-DGF(−) (n = 116), and pre-sensitized-DGF(+) (n = 19)]. We compared the incidence of biopsy-proven allograft rejection (BPAR), time-related change in allograft function, allograft or patient survival, and post-transplant complications across 4 subgroups. The incidence of acute antibody-mediated rejection (ABMR) was significantly higher in the pre-sensitized-DGF(+) subgroup than in other 3 subgroups. In addition, multivariable cox regression analysis demonstrated that pre-sensitization combined with DGF is an independent risk factor for the development of acute ABMR (hazard ratio 4.855, 95% confidence interval 1.499–15.727). Moreover, DGF and pre-sensitization showed significant interaction (p-value for interaction = 0.008). Pre-sensitization combined with DGF did not show significant impact on allograft function, and allograft or patient survival. In conclusion, the combination of pre-sensitization and DGF showed significant synergistic interaction on the development of allograft rejection after DDKT.Hanbi LeeYohan ParkTae Hyun BanSang Heon SongSeung Hwan SongJaeseok YangCurie AhnChul Woo YangByung Ha ChungThe Korean Organ Transplantation Registry Study GroupNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-11 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Hanbi Lee Yohan Park Tae Hyun Ban Sang Heon Song Seung Hwan Song Jaeseok Yang Curie Ahn Chul Woo Yang Byung Ha Chung The Korean Organ Transplantation Registry Study Group Synergistic impact of pre-sensitization and delayed graft function on allograft rejection in deceased donor kidney transplantation
description	Abstract The aim of this study is to investigate whether or not delayed graft function (DGF) and pre-transplant sensitization have synergistic adverse effects on allograft outcome after deceased donor kidney transplantation (DDKT) using the Korean Organ Transplantation Registry (KOTRY) database, the nationwide prospective cohort. The study included 1359 cases between May 2014 and June 2019. The cases were divided into 4 subgroups according to pre-sensitization and the development of DGF post-transplant [non-pre-sensitized-DGF(−) (n = 1097), non-pre-sensitized-DGF(+) (n = 127), pre-sensitized-DGF(−) (n = 116), and pre-sensitized-DGF(+) (n = 19)]. We compared the incidence of biopsy-proven allograft rejection (BPAR), time-related change in allograft function, allograft or patient survival, and post-transplant complications across 4 subgroups. The incidence of acute antibody-mediated rejection (ABMR) was significantly higher in the pre-sensitized-DGF(+) subgroup than in other 3 subgroups. In addition, multivariable cox regression analysis demonstrated that pre-sensitization combined with DGF is an independent risk factor for the development of acute ABMR (hazard ratio 4.855, 95% confidence interval 1.499–15.727). Moreover, DGF and pre-sensitization showed significant interaction (p-value for interaction = 0.008). Pre-sensitization combined with DGF did not show significant impact on allograft function, and allograft or patient survival. In conclusion, the combination of pre-sensitization and DGF showed significant synergistic interaction on the development of allograft rejection after DDKT.
format	article
author	Hanbi Lee Yohan Park Tae Hyun Ban Sang Heon Song Seung Hwan Song Jaeseok Yang Curie Ahn Chul Woo Yang Byung Ha Chung The Korean Organ Transplantation Registry Study Group
author_facet	Hanbi Lee Yohan Park Tae Hyun Ban Sang Heon Song Seung Hwan Song Jaeseok Yang Curie Ahn Chul Woo Yang Byung Ha Chung The Korean Organ Transplantation Registry Study Group
author_sort	Hanbi Lee
title	Synergistic impact of pre-sensitization and delayed graft function on allograft rejection in deceased donor kidney transplantation
title_short	Synergistic impact of pre-sensitization and delayed graft function on allograft rejection in deceased donor kidney transplantation
title_full	Synergistic impact of pre-sensitization and delayed graft function on allograft rejection in deceased donor kidney transplantation
title_fullStr	Synergistic impact of pre-sensitization and delayed graft function on allograft rejection in deceased donor kidney transplantation
title_full_unstemmed	Synergistic impact of pre-sensitization and delayed graft function on allograft rejection in deceased donor kidney transplantation
title_sort	synergistic impact of pre-sensitization and delayed graft function on allograft rejection in deceased donor kidney transplantation
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/2afe8166e69b4754a74ea60fc4d86177
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Synergistic impact of pre-sensitization and delayed graft function on allograft rejection in deceased donor kidney transplantation

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