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논문분류	춘계학술대회 초록집
제목	Clinical Significance of both de Novo Donor Specific anti-HLA Antibody and Kidney Donor Profile Index on Post-Transplant Clinical Outcomes in Deceased Donor Kidney Transplantation
저자	Woo-yeong Park, Ohyun Kwon, Yaerim Kim, Jin Hyuk Paek, Kyubok Jin, Sung Bae Park, Seungyeup Han
출판정보	2019; 2019(1):
키워드	Kidney transplantation \| Donor selection \| Antibody \| Graft rejection \| Graft survival
초록	We investigated the clinical significance of both Kidney Donor Profile Index (KDPI) and de novo donor specific anti-HLA antibody (dnDSA) on post-transplant clinical outcomes in deceased donor kidney transplantation (DDKT). Our study enrolled 133 patients who performed DDKT at Keimyung university Dongsan medical center between 2009 and 2017. We divided high KDPI and low KDPI by 65%, which is the median value of KDPI score. We investigated the incidence of delayed graft function (DGF), biopsy-proven acute rejection (BPAR), allograft function within 1 year after KT, allograft survival rate according to KDPI and dnDSA in DDKT. The study analyzed 68 kidney transplant recipients (KTRs) with high KDPI and 65 KTRs with low KDPI. The proportion of dnDSA tended to be higher in the high KDPI-KT group in comparison with low KDPI-KT group. There were no significant differences in the incidence of DGF between high KDPI-KT and low KDPI-KT groups. The incidence of BPAR in the high KDPI-KT group or dnDSA(+)-KT group tended to be higher in comparison with that in the low KDPI-KT group or dnDSA(-)-KT group, respectively. Allograft function within 1 year after KT was significantly lower in the high KDPI-KT group compared to the low KDPI-KT group, regardless of the presence of dnDSA. There were no significant differences of death-censored graft survival rate between high KDPI-KT and low KDPI-KT groups. However, death-censored graft survival rate was significantly the lowest in the high KDPI-dnDSA(+) KT group in comparison with high KDPI-dnDSA(-) KT, low KDPI-dnDSA(-) KT and low KDPI-dnDSA(+) KT groups (P=0.024). When KTRs from kidney donor with high KDPI was accompanied by dnDSA, post-transplant clinical outcomes was poor. Therefore, KTRs with low quality kidney should be thoroughly monitored for the prevention of dnDSA.
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