Publications by authors named "Kyu Ha Huh"
Pre-transplantation red blood cell transfusion (RBCT) is a well-recognized cause of allosensitization. However, the effects of RBCT after kidney transplantation remain controversial. This study evaluates the impacts of RBCT within the first 30 days post-transplantation (early RBCT) with regard to long-term patient and graft outcomes.
View Article and Find Full Text PDFLong-term, immunosuppression-free allograft survival has been induced in human and nonhuman primate (NHP) kidney recipients after nonmyeloablative conditioning and donor bone marrow transplantation (DBMT), resulting in transient mixed hematopoietic chimerism. However, the same strategy has consistently failed in NHP heart transplant recipients. Here, we investigated whether long-term heart allograft survival could be achieved by cotransplanting kidneys from the same donor.
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- ABO-incompatible kidney transplantation (KT) is increasingly used to address organ shortages, but high levels of anti-ABO antibodies can hinder successful transplantation despite existing desensitization methods.
- Eculizumab was used as an additional treatment to help patients with very high anti-ABO antibodies who did not respond to standard therapies, showing improvements in kidney function and antibody levels after transplant.
- The study indicates that short-term eculizumab treatment may effectively support ABOi KT patients by maintaining stable kidney function and reducing antibody levels, even in cases previously deemed challenging.
The optimal target blood pressure for kidney transplant (KT) patients remains unclear. We included 808 KT patients from the KNOW-KT as a discovery set, and 1,294 KT patients from the KOTRY as a validation set. The main exposures were baseline systolic blood pressure (SBP) at 1 year after KT and time-varying SBP.
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- - The study investigates the effects of coronary artery calcification score (CACS) and abdominal aortic calcification score (AACS) on cardiovascular and renal outcomes in kidney transplant patients, which have not been thoroughly examined before.
- - It categorizes 944 kidney transplant recipients into low, medium, and high groups based on their CACS and AACS, with the primary focus on cardiovascular events and secondary outcomes like all-cause mortality and kidney function decline.
- - The results show that patients in the high CACS and AACS groups had significantly higher risks for cardiovascular events and all-cause mortality, but there was no notable difference in renal outcomes across the groups.
Article Synopsis
- Ischemia-reperfusion injury (IRI) during myocardial infarction lacks effective treatments, but bilirubin's anti-inflammatory and antioxidant properties show potential for therapy.
- The study used a rat model to assess bilirubin nanoparticles, identifying 3,616 protein groups and observing distinct protein expression changes with and without bilirubin treatment.
- Significant findings included upregulation of Wnt and insulin signaling pathways and Golgi markers, indicating the need for more research on bilirubin nanoparticles for cardiac protection in humans.
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- The study investigates the best tacrolimus trough levels to maximize kidney transplant success and minimize patient risks across a large cohort of 11,868 recipients from five medical centers.
- Findings suggest that maintaining tacrolimus levels between 5.0-7.9 ng/mL in the first two years post-transplant decreases risks of graft failure and severe complications like infections and malignancies.
- The research supports specific tacrolimus dosage guidelines, aiming to improve long-term outcomes for kidney transplant patients.
Donor fat-to-muscle ratio and kidney transplant outcomes: A proposition of metabolic memory.
Diabetes Metab Res Rev
February 2024
Aims: The impact of donor abdominal fat-to-muscle ratio (FMR) on kidney transplant (KT) outcomes was assessed. Given the transient nature of the donor's metabolic environment in transplant recipients, this study investigated the capacity of body composition to induce metabolic memory effects.
Materials And Methods: KT patients (n = 895) who received allografts from living donors (2003-2013) were included.
Background: Vascular calcification and stiffness contribute to increased cardiovascular morbidity in patients with chronic kidney disease. This study investigated associations between serum osteoprotegerin (OPG) levels and vascular calcification or stiffness to assess cardiovascular and graft outcomes in kidney transplant patients.
Methods: The KoreaN cohort study for Outcome in patients With Kidney Transplantation was a prospective multicenter cohort study.
Article Synopsis
- Death with a functioning graft is a significant cause of graft loss in kidney transplant patients, but factors predicting it are not well understood.
- This study analyzed the relationship between the creatinine-cystatin C ratio and mortality among 1,592 kidney transplant recipients, revealing that a low ratio increases the risk of death with a functioning graft.
- In particular, those in the lowest ratio tertile had significantly lower survival rates, with infections being the leading cause of death in this group.
Cardiovascular disease remains a leading cause of morbidity and mortality after kidney transplantation (KT). Although statins reduce cardiovascular risk and have renal benefits in the general population, their effects on KT recipients are not well-established. We studied the effects of early statin use (within 1-year post-transplantation) on long-term outcomes in 714 KT recipients from the Korean cohort study for outcome in patients with KT.
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- The study investigates the relationship between serum activin A levels and kidney transplant outcomes, focusing on chronic kidney disease effects.
- Researchers analyzed data from 860 kidney transplantation patients, measuring activin levels before and one year after the procedure to determine the risk of graft failure and kidney function decline.
- Results showed that higher activin levels one year post-transplant correlated with increased risk of poor allograft outcomes and greater coronary artery calcification over time.
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- Robotic kidney transplantation (RKT) shows promising surgical outcomes, but there is limited data on its feasibility for surgeons without prior minimally invasive surgery (MIS) experience.
- A study conducted at Severance Hospital analyzed 50 patients who underwent RKT compared to 104 who had open kidney transplantation (OKT), revealing longer operation times for RKT but comparable outcomes in terms of renal function and fewer complications.
- The single surgeon achieved competency in RKT after 15 cases, indicating that with proper training, surgeons without MIS experience can effectively perform robotic procedures.
Introduction: ABO-incompatible (ABOi) living donor kidney transplantation (LDKT) is considered only for patients who do not have an ABO-compatible (ABOc) LD. Therefore, a clinically practical question is whether to proceed with ABOi LDKT or remain on dialysis while waiting for ABOc deceased donor kidney transplantation (DDKT). However, this issue has not been addressed in Asian countries, where ABOi LDKT programs are more active than DDKT programs.
View Article and Find Full Text PDFVitamin D (25[OH]D) insufficiency and fibroblast growth factor 23 (FGF23) elevation are usually attenuated after kidney transplantation (KT). However, elevated FGF23 may be associated with poor graft outcomes and vitamin D insufficiency after KT. This study investigated the effect of pretransplant FGF23 levels on post-KT 25(OH)D status and graft outcomes.
View Article and Find Full Text PDFBackground: The Living Kidney Donor Profile Index (LKDPI) was developed in the United States to predict graft outcomes based on donor characteristics. However, there are significant differences in donor demographics, access to transplantation, proportion of ABO incompatibility, and posttransplant mortality in Asian countries compared with the United States.
Methods: We evaluated the clinical relevance of the LKDPI score in a Korean kidney transplant cohort by analyzing 1860 patients who underwent kidney transplantation between 2000 and 2019.
Background: The impact of circulating sclerostin levels on vascular calcification has shown conflicting results depending on the target population and vascular anatomy. This study investigated the associations of sclerostin levels with vascular outcomes in kidney transplant patients.
Methods: In a prospective observational study of the Korean Cohort Study for Outcome in Patients with Kidney Transplantation, 591 patients with serum sclerostin level data prior to transplantation were analyzed.
Patients with end stage kidney disease (ESKD) and a previous acute myocardial infarction (AMI) have less access to KT. Data on ESKD patients with an AMI history who underwent first KT or dialysis between January 2007 and December 2018 were extracted from the Korean National Health Insurance Service. Patients who underwent KT ( = 423) were chronologically matched in a 1:3 ratio with those maintained on dialysis ( = 1,269) at the corresponding dates, based on time-conditional propensity scores.
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- De novo donor-specific antibody (dnDSA) is linked to an increased risk of kidney graft failure, but the benefits of treating subclinical dnDSA are unclear.
- A clinical trial in Korea investigated the effectiveness of high-dose intravenous immunoglobulin (IVIG) combined with rituximab versus rituximab alone in kidney transplant patients with subclinical dnDSA.
- Results showed significant dnDSA titer declines in both treatment groups after 12 months, but there were no differences between the two groups, and no adverse kidney outcomes were reported.
Introduction: Early antibody-mediated rejection has been reported to increase chronic antibody-mediated rejection and decrease graft survival in kidney transplantation. However, the impact of early antibody-mediated rejection in ABO-incompatible kidney transplantation remains unclear.
Methods: We retrospectively analyzed living-donor kidney transplantation patients from two Korean centers.
Article Synopsis
- The study explored how left ventricular global longitudinal strain (LV GLS) in patients with end-stage renal disease changes after kidney transplantation (KT).
- A total of 488 patients were analyzed, considering their LV GLS values before and within three years after KT, revealing notable variations in heart structure and function based on initial LV GLS levels.
- Results showed that patients with severely impaired pre-KT LV GLS experienced the most significant improvements in heart function after KT, demonstrating positive overall changes in LV structure across all pre-KT LV GLS categories.
Atypical hemolytic uremic syndrome (aHUS) is a form of thrombotic microangiopathy (TMA) that can result in end-stage renal disease. Patients with aHUS often have predisposing dysfunction in the complement pathway, and continuous activation of complement proteins can be triggered after transplantation. Here, we report the first successful case of aHUS treatment in a kidney transplant recipient with early use of a C5 inhibitor, eculizumab, in South Korea.
View Article and Find Full Text PDFMalakoplakia is a rare, granulomatous disease that usually affects immunocompromised individuals and is generally associated with poor graft and patient survival. We present a case of renal malakoplakia after kidney transplantation (KT). A 33-year-old female patient with chronic kidney disease underwent living-donor KT at Severance Hospital.
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- Muscle wasting in chronic kidney disease leads to higher rates of cardiovascular issues and death, but its impact on kidney transplant outcomes has been unclear.
- In a study of 623 kidney transplant patients, those with low pretransplantation skeletal muscle mass had a significantly higher risk of mortality and hospital readmissions compared to those with normal muscle mass.
- While graft survival rates were similar for both groups, patients with low muscle mass showed higher creatinine-based eGFRs, suggesting they may have different kidney function assessments post-transplant.
Iron plays an important role in hemodynamics and the immunity, independent of anemia. Since dynamic changes occur in iron storage after kidney transplantation (KT), we investigated the association between iron status and kidney outcomes in KT patients. We analyzed data from the KoreaN cohort study for Outcome in patients With KT (KNOW-KT).
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