The risk factors for treatment-related mortality within first three months after kidney transplantation

• Published in: PloS one 2020-12, Vol.15 (12), p.e0243586-e0243586
• Main Authors: Kim, Ye Na, Kim, Do Hyoung, Shin, Ho Sik, Lee, Sangjin, Lee, Nuri, Park, Min-Jeong, Song, Wonkeun, Jeong, Seri
• Format: Article
• Language: English
• Subjects: ABO system; Adult; Age; Albumins; Biology and Life Sciences; Cohort Studies; Female; Glucose; Glutamic oxaloacetic transaminase; Health care facilities; Health risks; Hospitals; Humans; Hyperglycemia; Incompatibility; Internal medicine; Kidney transplantation; Kidney Transplantation - mortality; Kidney transplants; Kidneys; Laboratories; Male; Medical schools; Medicine; Medicine and Health Sciences; Middle Aged; Mortality; Multivariate analysis; Nephrology; Organ transplant recipients; Patient outcomes; Patients; Personal information; Physical Sciences; Prognosis; Proportional Hazards Models; Research and Analysis Methods; Risk analysis; Risk Factors; Risk groups; Risk management; South Korea; Surgery; Tissue Donors; Transaminase; Transplants & implants; Treatment Outcome
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0243586

Mortality at an early stage after kidney transplantation is a disastrous event. Treatment-related mortality (TRM) within 1 or 3 months after kidney transplantation has been rarely reported. We designed a cohort study using the national Korean Network for Organ Sharing database that includes information about kidney recipients between 2002 and 2016. Their demographic, and laboratory data were collected to analyze risk factors of TRM. A total of 19,815 patients who underwent kidney transplantation in any of 40 medical centers were included. The mortality rates 1 month (early TRM) and 3 months (TRM) after transplantation were 1.7% (n = 330) and 4.1% (n = 803), respectively. Based on a multivariate analysis, older age (hazard ratio [HR] = 1.044), deceased donor (HR = 2.210), re-transplantation (HR = 1.675), ABO incompatibility (HR = 1.811), higher glucose (HR = 1.002), and lower albumin (HR = 0.678) were the risk factors for early TRM. Older age (HR = 1.014), deceased donor (HR = 1.642), and hyperglycemia (HR = 1.003) were the common independent risk factors for TRM. In contrast, higher serum glutamic oxaloacetic transaminase (HR = 1.010) was associated with TRM only. The identified risk factors should be considered in patient counselling, and management to prevent TRM. The recipients assigned as the high-risk group require intensive management including glycemic control at the initial stage after transplant.