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Abstract: TH-PO1002

Pre- and Post-Transplant Serum Alkaline Phosphatase Predicts Graft Failure and Mortality in Kidney Transplant Recipients

Session Information

Category: Transplantation

  • 1702 Transplantation: Clinical and Translational

Authors

  • Kim, Yong Chul, Seoul National University Hospital, Seoul, Korea (the Republic of)
  • Park, Seokwoo, Seoul National University Hospital, Seoul, Korea (the Republic of)
  • Lee, Hajeong, Seoul National University Hospital, Seoul, Korea (the Republic of)
  • Lim, Chun Soo, Seoul National University College of Medicine, Seoul, Korea (the Republic of)
  • Kim, Yon Su, Seoul National University Hospital, Seoul, Korea (the Republic of)
  • Lee, Jung Pyo, Seoul National University College of Medicine, Seoul, Korea (the Republic of)
Background

Recent studies showed that high levels of serum alkaline phosphatase (AlkPhos) are associated with all-cause or cardiovascular death in chronic kidney diseases. However, there are apparently no data on the effect of AlkPhos in kidney transplant recipients (KTRs). The aim of this study was to evaluate whether serum AlkPhos is associated with graft failure and mortality after kidney transplantation.

Methods

Among the 3029 kidney transplant recipients (KTRs) who were enrolled in a multicenter cohort, we examined the association of pre- and post-transplant serum AlkPhos levels and long-term outcomes in KTRs.

Results

Pre-transplant serum AlkPhos ≥ 80 IU/L was associated with a hazard ratio (HR) for graft failure of 1.571 (95% CI 1.146-2.152, P = 0.005) in a fully adjusted model. Death-censored graft failure (DCGF) rate in kidney recipients gradually increased along the increments of AlkPhos. Also, a rise in serum AlkPhos by 40 IU/L during the first 3 months after kidney transplantation was associated with higher rates of DCGF (HR 2.353, 95% CI 1.506-3.676) and higher rates of mortality (HR: 2.733, 95% CI 1.479-5.050). Cox regression models using time-varying AlkPhos for initial 3 months after transplantation demonstrated significant relationships between AlkPhos and DCGF (HR 1.39, 95% CI 1.04-1.84) or mortality (HR 2.14, 95% CI 1.39-3.27).

Conclusion

Increased pre- and post-transplant serum AlkPhos and a rise of serum AlkPhos during early period after kidney transplantation is associated with graft failure and mortality in kidney transplant recipients.