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논문분류	춘계학술대회 초록집
제목	Factors Affecting Mortality during Waiting Time for Kidney Transplantation: A Nationwide Population-based Cohort Study using The Korean Network for Organ Sharing (KONOS) database
저자	Sunhwa Lee1, Kyung Don Yoo1, Jung Nam An2, Yun Kyu Oh2, Chun Soo Lim2, Yon Su Kim1, Jung Pyo Lee2
출판정보	2015; 2015(1):
키워드	신장이식, 이식 대기 시간, 사망률
초록	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. Patients who have higher body mass also show increased mortality (p=0.048) before transplantation. However, blood type, gender and re-transplantation were not associated with mortality. 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, and obese with higher risk for mortality during waiting time.
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