Jung Cheol Woong, Park Kwan Tae, Gwon Jun Gyo, Ko Sun-Young, Kim Myung-Gyu
Department of Surgery, Korea University College of Medicine, Seoul, Korea.
Department of Surgery, Mongolian National University of Medical Science, Ulan Bator, Mongolia.
Transplant Proc. 2019 Oct;51(8):2555-2558. doi: 10.1016/j.transproceed.2019.03.062. Epub 2019 Aug 22.
Among foreigners undergoing kidney transplantation (KT) in Korea, Mongolians are the most common, and most of these cases are conducted at our center. We report the immunologic characteristics and clinical outcomes of these patients.
Consecutive Mongolian patients who underwent KT from September 2009 to August 2017 in our center were retrospectively analyzed. Pre- and post-transplant HLA antibody status and clinical data of the Mongolian patients were collected and compared with the Korean patients who underwent living donor KT during the same period.
Sixty-two Mongolian and 85 Korean patients received KT and were followed up for 20.9 and 50.8 months (P = .01), respectively. Before transplantation, 17.7% of the Mongolian patients and 7.1% of the Korean patients were highly sensitized (P = .05). The patients were monitored consistently throughout the entire post-transplant period. Follow-up loss occurred in some cases. Of the patients, 32 Mongolian patients and 79 Korean patients were monitored for post-transplant HLA antibodies at any time point. Estimated glomerular filtration rates were comparable between Mongolian and Korean patients at 1 month (77.1 vs 71.5 mL/min/1.73m, P = .21) and 1 year (64.6 vs 68.7 mL/min/1.73m, P = .25) after transplantation but tended to be different at 3 years (57.2 vs 67.3 mL/min/1.73m, P = .06) and 5 years (56.9 vs 73.1 mL/min/1.73m, P = .04) post transplant.
Mongolian patients undergoing KT in Korea were often highly sensitized. Mean follow-up time was short and follow-up loss was common in Mongolian patients compared with Korean patients. Cautious follow-up is needed for foreigner transplant recipients, especially for those at high-risk immunologically, to achieve better outcomes.
在韩国接受肾移植（KT）的外国人中，蒙古人最为常见，且大多数此类病例在我们中心进行。我们报告这些患者的免疫特征和临床结局。
对2009年9月至2017年8月在我们中心接受KT的连续蒙古患者进行回顾性分析。收集蒙古患者移植前后的HLA抗体状态和临床数据，并与同期接受活体供肾KT的韩国患者进行比较。
62例蒙古患者和85例韩国患者接受了KT，分别随访了20.9个月和50.8个月（P = 0.01）。移植前，17.7%的蒙古患者和7.1%的韩国患者高度致敏（P = 0.05）。在整个移植后期间对患者进行持续监测。部分病例出现随访失访。在任何时间点，对32例蒙古患者和79例韩国患者进行了移植后HLA抗体监测。移植后1个月（77.1对71.5 mL/min/1.73m²，P = 0.21）和1年（64.6对68.7 mL/min/1.73m²，P = 0.25）时，蒙古患者和韩国患者的估计肾小球滤过率相当，但移植后3年（57.2对67.3 mL/min/1.73m²，P = 0.06）和5年（56.9对73.1 mL/min/1.73m²，P = 0.04）时倾向于不同。
在韩国接受KT的蒙古患者常高度致敏。与韩国患者相比，蒙古患者的平均随访时间短且随访失访常见。对于外国移植受者，尤其是免疫高风险者，需要谨慎随访以获得更好的结局。
