THE KOREAN ORGAN TRANSPLANTATION REGISTRY (KOTRY): FIRST OFFICIAL KIDNEY TRANSPLANTATION REPORT

Abstract

Korean Organ Transplantation Registry Study Group. Korean Organ Transplantation Registry (KOTRY), a first prospective-deigned national transplantation registry in Korea, was launched in 2014. This is an initial report on the status of patients received kidney transplants over the past 4 years. A total of 4839 kidney transplants (KTs) from 32 transplant centers were collected from April 2014 to December 2018. Among these, 3039 patients received kidneys from living donors, and 1800 patients received kidneys from deceased donors. We analyzed baseline characteristics of recipients and donors, and short-term post-transplantation outcomes. Among 4839 KTs, 3039 patients (62.8%) received kidneys from living donors (LDs), and 1800 patients (37.2%) received kidneys from deceased donors (DDs). The average recipient age was 48 years; there were 1774 (58.4%) male recipients. The mean age of patients undergoing LD kidney transplantation was 4 years younger than that of patients undergoing DD kidney transplantation. Even though glomerulonephritis was the most common cause of end-stage renal disease (33.3%), the number of diabetic nephropathy was increasing. At the time of transplantation, 10.9% and 29.8% of KTs had cardiovascular disease and diabetes, respectively. The average donor age was 47 years; there was 2593 (53.6%) male donors. The mean age of LD was 2 years younger than that of DD. Expanded criteria donors (30.8%) were frequently used. During follow-up period, new-onset cardiac events and NODAT were identified in 9.4% and 8.4% of the recipients, respectively. The overall 1- and 4-year patient survival rates were 98.4% and 96.9%, respectively. During the follow-up period, 84 KTs died, and the most common cause of death was infection (47.6%). The overall 1- and 4-year graft survival rates were 97.1% and 93.0%, respectively, and the most common cause of graft loss was rejection (43.5%). The overall 1- and 4-year rejection-free survival rates were 81.8% and 72.2%, respectively. In multivariate analysis, older recipients, history of cardiovascular disease, an increasing number of HLA mismatch, bortezomib induction, cyclosporine use at discharge, no anti-metabolite at discharge, an increase serum creatinine at discharge, and long cold ischemic time were significantly associated with death after transplantation. And no anti-metabolite at discharge, an increase serum creatinine at discharge and long cold ischemic time were significantly associated with graft loss after transplantation. With the establishment of KOTRY, it is possible to present the first nationwide epidemiological data of Korean kidney transplantation. KOTRY will provide better understanding regarding nationwide epidemiological data for kidney transplantation in Korea. Novartis Korea, Ltd.. Research of Korea Centers for Disease Control and Prevention (2014-ER6301-00, 2014-ER6301-01, 2014-ER6301-02, 2017-ER6301-00, 2017-ER6301-01).