Publications by authors named "Su Kil Park"
Article Synopsis
- ACE inhibitors and angiotensin receptor blockers (ACEi/ARBs) may pose risks for acute kidney injury, but their impact before kidney transplantation (KT) is unclear.
- A study analyzed 1187 patients who underwent living-donor KT, comparing outcomes for those who used ACEi/ARBs and those who did not.
- Results showed no significant differences in delayed graft function, postoperative renal function, hyperkalemia events, rejection rates, or graft survival between the two groups, suggesting preoperative use of ACEi/ARBs is safe in this context.
Article Synopsis
- This study examines the outcomes of kidney transplantation in patients who have also received a liver transplant (LTKT) versus those who only had kidney transplants (KTA) from 2005 to 2020.
- It included 4312 patients, with 44 in the LTKT group and 4268 in the KTA group, and used statistical methods to balance the groups for fair comparison.
- The results showed no significant difference in graft survival rates, but the LTKT patients experienced better rejection-free survival than the KTA group.
Background: Posttransplantation diabetes mellitus (PTDM) is a crucial problem after kidney transplantation. We aimed to determine whether metformin affects cardiovascular and graft outcomes in patients with PTDM.
Methods: This retrospective cohort study included 1,663 kidney transplant recipients without preexisting diabetes mellitus.
Background: Pathologic diagnosis of antibody-mediated rejection (ABMR) in ABO-incompatible (ABOi) transplantation patients is often challenging because patients without ABMR are frequently immunopositive for C4d. The aim of this study was to determine whether C4d positivity with microvascular inflammation (MVI), in the absence of any detectable donor-specific antibodies (DSAs) in ABOi patients, could be considered as ABMR.
Methods: A retrospective study of 214 for-cause biopsies from 126 ABOi kidney transplantation patients was performed.
Article Synopsis
- Researchers studied 172 people with kidney diseases using a special test called whole exome sequencing (WES) to find genetic problems.
- They discovered that WES could diagnose genetic diseases in 63 of those patients, which is about 36.6%.
- The testing was most helpful for younger patients (under 6 years old), and it even changed the way 10 of the patients were treated after finding their genetic issues.
Background: Recurrent focal segmental glomerulosclerosis (FSGS) after kidney transplantation (KT) is a serious complication and a significant risk factor for graft failure. However, there is no clear evidence of the effectiveness of pre-transplant treatment using plasmapheresis (PP) or rituximab in preventing post-operative FSGS recurrence after KT.
Methods: This single-center retrospective study included 99 adult patients with biopsy-proven primary FSGS who underwent KT between 2007 and 2018.
Article Synopsis
- Hyperparathyroidism is common in chronic kidney disease patients and can persist after kidney transplantation, with treatment options still unclear.
- A study of 83 patients showed that those who underwent parathyroidectomy experienced greater reductions in serum calcium and parathyroid hormone (PTH) levels compared to those treated with cinacalcet one year post-transplantation.
- While both treatments improved biochemical outcomes, there were no significant differences in kidney transplant rejection or related complications between the two groups, suggesting parathyroidectomy may be more effective but requires careful monitoring of kidney function.
Background: Recent studies have shown that high levels of serum alkaline phosphatase (ALP) are associated with all-cause and cardiovascular death among patients undergoing hemodialysis. However, there is limited knowledge on the effect of ALP level in kidney transplant recipients (KTRs). The aim of this study was to evaluate if serum ALP levels before and after transplant and the changes in ALP levels are associated with graft failure and mortality.
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- This study investigated the impact of rituximab on cancer occurrence and mortality rates in kidney transplant recipients, comparing different patient groups based on the timing and use of the drug.* -
- Among 5,000 kidney transplant recipients, the incidence of malignant tumors over five years was similar across groups: era1 (3.1%), era2-rit- (4.3%), and era2-rit+ (3.5%), showing no significant difference.* -
- The findings indicate that using single-dose rituximab does not significantly increase cancer risk or mortality in kidney transplant patients, but hepatocellular carcinoma was identified as having a notably high mortality risk.*
Article Synopsis
- * The study utilized flow cytometry to measure isoagglutinin titers and discovered that an increased level of IgG1 subclass was responsible for a hyperacute rejection case, leading to graft removal.
- * This case highlights the importance of monitoring isoagglutinin subclasses in blood group O recipients during ABO-incompatible transplants to improve outcomes and avoid similar rejections in the future.
The focus of studies on kidney transplantation (KT) has largely shifted from T-cell mediated rejection (TCMR) to antibody-mediated rejection (ABMR). However, there are still cases of pure acute TCMR in histological reports, even after a long time following transplant. We thus evaluated the impact of pure TCMR on graft survival (GS) according to treatment response.
View Article and Find Full Text PDFBackground: We aimed to describe the characteristics of immunoglobulin A nephropathy (IgAN) in Korea with assessment for time trends.
Methods: We performed a multicenter retrospective observational cohort study including biopsy-confirmed native IgAN cases from four tertiary hospitals in Korea. Time eras of diagnosis were stratified into 1979-2003, 2004-9 and 2010-17.
To investigate the characteristics of lymphedema in patients treated with mammalian target of rapamycin (mTOR) inhibitors and delineate complex decongestive therapy (CDT) outcomes. We retrospectively analyzed 24 patients with mTOR inhibitor-induced lymphedema and 7 lymphedema patients (control) not treated with mTOR inhibitors, who visited the lymphedema clinic of the department of rehabilitation medicine from March 2016 to December 2019. We comprehensively reviewed clinical features, medication history, associated diseases, lymphoscintigraphy, lower extremity computed tomography venography (LE CTV), and the effect of CDT.
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- * The study analyzed 1732 patients stratified into four groups based on ABO and HLA compatibility, revealing that the ABOi/HLAi group had the lowest 5-year graft survival rate and a significant increase in mortality due to infections.
- * Key findings indicate that both ABOi/HLAi and infections are significant risk factors for acute rejection, emphasizing the need for careful monitoring and management in these patients.
BACKGROUND Kidney donors may be at increased risk for end-stage renal disease (ESRD) as well as cardiovascular and all-cause mortality. In particular, data on long-term safety after kidney donation in Asian populations are lacking. We aimed to assess the safety of live kidney donation in Korean donors by using a matched control group.
View Article and Find Full Text PDFObjectives: We evaluated the effectiveness of IGRA-based isoniazid (INH) treatment with the diagnostic value of quantitative IGRA titer for post-transplant tuberculosis (TB) in kidney transplant (KT) recipients.
Methods: All adult KT recipients were enrolled from January 2014 to December 2017. The development of TB after KT was observed, stratified by quantitative IGRA results as well as by IGRA results with/without INH treatment.
Background: Pneumocystis pneumonia (PCP) is a life-threatening fungal infection that can occur in kidney transplantation (KT) recipients. A growing number of KT recipients are receiving perioperative treatment with rituximab, which is associated with prolonged B-cell depletion and possible risk of PCP occurrence; however, the optimal prophylaxis duration according to rituximab treatment is yet unknown. We compared the occurrence of PCP and the duration of prophylaxis in KT recipients according to rituximab treatment.
View Article and Find Full Text PDFBackground: Recent advances in desensitization techniques and immunosuppressive therapy have led to improved outcomes after ABO-incompatible (ABO-i) kidney transplantation (KT). However, questions remain unanswered, particularly regarding which type of ABO isoagglutinin-immunoglobulin M (IgM) or immunoglobulin M (IgG)-is significantly involved in antibody-mediated rejection (AMR).
Study Design And Methods: We retrospectively analyzed data from 120 patients who underwent ABO-i KT between 2012 and 2014.
Background: Previous studies have recommended a 2- to 5-year waiting time prior to kidney transplantation (KT) in patients with end-stage renal disease (ESRD) and symptomatic renal cell carcinoma (RCC) and no delay for incidental early-stage RCC. Data on Asian KT recipients are unavailable.
Methods: This is a Korean single-center retrospective study on 35 KT recipients with ESRD and RCC.
Article Synopsis
- Darbepoetin-alfa is an ESA that offers consistent hemoglobin (Hb) levels, and the study aimed to compare its effectiveness and safety with a biosimilar, CKD-11101, in hemodialysis patients.
- Conducted across 24 Korean centers over two years, 403 patients were randomly assigned to receive either CKD-11101 or darbepoetin-alfa, and after a 24-week period, 325 patients completed the study.
- Results indicated no significant differences in Hb changes, dosing, or safety between the two treatments, suggesting that CKD-11101 is equally effective and safe as darbepoetin-alfa in this patient group.
Epigallocatechin-3-gallate (EGCG), the most abundant polyphenol in green tea leaves, has anti-inflammatory effects. In this study, we investigated the mechanism by which EGCG attenuates the effects of lipopolysaccharide (LPS), an agonist of toll-like receptor 4 (TLR4), in cultured human aortic endothelial cells (HAECs). The increase in the expression of intercellular adhesion molecule-1 (ICAM-1) induced by LPS (100 ng/ml) was effectively attenuated by pretreatment with EGCG (50 μM).
View Article and Find Full Text PDFBackground: Although immunoglobulin A nephropathy (IgAN) is associated with an increased risk of renal allograft failure, evidences for its treatment, including renin-angiotensin-aldosterone system blockade (RAASB) usage, remain limited.
Methods: In this bi-center retrospective cohort study, we included patients who were recently diagnosed with IgAN through allograft biopsies. We identified their 6-month antihypertensive medication prescriptions and investigated the association between the medication types, albuminuria changes, and risk of 5-year death-censored-graft-failure (DCGF).
Article Synopsis
- Short-term hemoglobin (Hb) variability in chronic kidney disease (CKD) patients on hemodialysis (HD) can be influenced by the day of Hb measurement, with mid-week sampling being preferable to reduce variability.
- A study conducted at Asan Medical Center evaluated 92 patients after changing their Hb measurement day from early week to mid-week, examining its effects on Hb levels and erythropoiesis-stimulating agent (ESA) doses.
- Results showed no significant difference in mean Hb levels between early- and mid-week, but lower ESA and intravenous iron doses and reduced weight gains were associated with mid-week measurements, suggesting improved management for CKD patients.
Article Synopsis
- A recent study analyzed kidney transplant recipients with allograft IgA nephropathy (IgAN) using the updated Oxford classification, focusing on its clinical significance.
- The study included 333 patients and found that certain components of the MEST-C scores were linked to worse outcomes, particularly in those with multiple components.
- The results suggest that MEST-C scores should be reported in allograft biopsies and interpreted based on the primary cause of end-stage renal disease (ESRD).
Background: Crossmatching (XM) between organ donors and recipients is correlated with clinical outcomes. This study evaluates the results of HLA-incompatible kidney transplant (HLA-i KT) according to pre-transplant XM modalities.
Methods: This study included 731 consecutive patients.