대한이식학회지 (Korean Journal of Transplantation)
- 제31권4호
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- Pages.200-206
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- 2017
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- 2671-8790(pISSN)
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- 2671-8804(eISSN)
DOI QR Code
Predictors of Avascular Necrosis after Kidney Transplantation
- Ko, Young Min (Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine) ;
- Kwon, Hyunwook (Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine) ;
- Chun, Sung Jin (Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine) ;
- Kim, Young Hoon (Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine) ;
- Choi, Ji Yoon (Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine) ;
- Shin, Sung (Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine) ;
- Jung, Joo Hee (Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine) ;
- Park, Su-Kil (Division of Nephrology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
- Han, Duck Jong (Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine)
- 투고 : 2017.10.02
- 심사 : 2017.12.21
- 발행 : 2017.12.30
초록
Background: Risk factors for bone avascular necrosis (AVN), a common late complication after kidney transplantation (KT), are not well known. Methods: Patients that underwent living-donor KT at Asan Medical Center between January 2009 and July 2016 were included in this retrospective study to determine the incidence and risk factors for AVN after KT. Results: Among 1,570 patients that underwent living-donor KT, 33 (2.1%) developed AVN during a mean follow-up of 49.8±25.0 months. Additionally, AVN was diagnosed at a mean of 13.9±6.6 months after KT. The mean cumulative corticosteroid dose during the last follow-up in patients without AVN (9,108±3,400 mg) was higher than that that in patients with AVN (4,483±1,114 mg) until AVN development (P<0.01). More patients among those with AVN (n=4, 12.1%) underwent steroid pulse treatment because of biopsy-proven rejections during the first 6 months after KT than patients without AVN (n=68, 4.4%; P=0.04). Female (hazard ratio [HR], 2.29; P=0.04) and steroid pulse treatment during the first 6 months (HR, 2.31; P=0.02) were significant AVN risk factors as revealed by the Cox proportional multivariate analysis. However, no significant differences in rejection-free graft survival rates were observed between the two groups (P=0.67). Conclusions: Steroid pulse treatment within 6 months of KT and being female were independent risk factors for AVN development.