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Research Article
Byung Ha Chung
Seoul St. Mary's Hospital
Corresponding Author
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The aim of this study is to investigate whether or not delayed graft function (DGF) and pre-transplant sensitization has a synergistic adverse effect on allograft outcome after deceased donor kidney transplantation (DDKT) using the Korean Organ Transplantation Registry (KOTRY) database, the nationwide prospective cohort. The study included 1,370 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=1100), non-pre-sensitized-DGF(+)(n=133), pre-sensitized-DGF(-)(n=116), and pre-sensitized-DGF(+)(n=21)). 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 overall BPAR and 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 both overall BPAR (hazard ratio 3.253, p = 0.005) and acute ABMR (hazard ratio 7.589, p < 0.001). Moreover, DGF and pre-sensitization showed significant interaction. Pre-sensitization combined with DGF did not show significant impact on allograft function, and allograft or patient survival. In conclusion, pre-sensitization and DGF had a synergistic adverse impact on allograft rejection after DDKT.
Keywords
delayed graft function (DGF), deceased donor kidney transplantation (DDKT), post-transplant complications
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The full text of this article is available to read as a PDF.
No competing interests reported.
This is a list of supplementary files associated with this preprint. Click to download.
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View the published article at Scientific Reports.
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No community comments so far
Editorial decision: Major revision
On 07 May, 2021
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Received 22 Apr, 2021
Reviewers agreed
On 26 Mar, 2021
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Editor invited
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A new preprint design is coming!
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See the published version of this preprint at Scientific Reports.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research Article
Byung Ha Chung
Seoul St. Mary's Hospital
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
View the published article at Scientific Reports.
Version 1
Posted 25 Feb, 2021
No community comments so far
Editorial decision: Major revision
On 07 May, 2021
Reviews received
Received 22 Apr, 2021
Reviewers agreed
On 26 Mar, 2021
Reviewers invited
Invitations sent on 17 Mar, 2021
Editor assigned
On 15 Mar, 2021
Editor invited
On 24 Feb, 2021
Submission checks complete
On 24 Feb, 2021
First submitted
On 09 Feb, 2021
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at Scientific Reports.
The aim of this study is to investigate whether or not delayed graft function (DGF) and pre-transplant sensitization has a synergistic adverse effect on allograft outcome after deceased donor kidney transplantation (DDKT) using the Korean Organ Transplantation Registry (KOTRY) database, the nationwide prospective cohort. The study included 1,370 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=1100), non-pre-sensitized-DGF(+)(n=133), pre-sensitized-DGF(-)(n=116), and pre-sensitized-DGF(+)(n=21)). 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 overall BPAR and 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 both overall BPAR (hazard ratio 3.253, p = 0.005) and acute ABMR (hazard ratio 7.589, p < 0.001). Moreover, DGF and pre-sensitization showed significant interaction. Pre-sensitization combined with DGF did not show significant impact on allograft function, and allograft or patient survival. In conclusion, pre-sensitization and DGF had a synergistic adverse impact on allograft rejection after DDKT.
Figure 1
Figure 2
Figure 3
Figure 4
The full text of this article is available to read as a PDF.
No competing interests reported.
This is a list of supplementary files associated with this preprint. Click to download.
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