ABSTRACT
Background@#This study investigated the associations between transfusion of different types of red blood cell (RBC) preparations and kidney allograft outcomes after kidney transplantation (KT) over a 16-year period in Korea using a nationwide population-based cohort. @*Methods@#We investigated the reported use of RBCs during hospitalization for KT surgery, rejection, and graft failure status using nationwide data from the National Health Information Database (2002–2017). The associations between the type of perioperative RBC product and transplant outcomes were evaluated among four predefined groups: no RBC transfusion, filtered RBCs, washed RBCs, and packed RBCs (pRBCs). @*Results@#A total of 17,754 KT patients was included, among which 8,530 (48.0%) received some type of RBC transfusion. Of the patients who received RBC transfusion, 74.9%, 19.7%, and 5.4% received filtered RBCs, pRBCs, or washed RBCs, respectively. Regardless of the type of RBC products, the proportions of acute rejection and graft failure was significantly greater in patients receiving transfusion (P < 0.001). Cox proportional hazards regression analyses showed that the filtered RBC and pRBC groups were significantly associated with both rejection and graft failure. The washed RBC group also had hazard ratios greater than 1.0 for rejection and graft failure, but the association was not significant. Rejection-free survival of the pRBC group was significantly lower than that of the other groups (P < 0.001, log-rank test), and graft survival for the no RBC transfusion group was significantly greater than in the other groups (P < 0.001, log-rank test). @*Conclusion@#Perioperative RBC transfusion was associated with poor graft outcomes.Notably, transfusion of pRBCs significantly increased transplant rejection. Therefore, careful consideration of indications for RBC transfusion and selection of the appropriate type of RBCs is necessary, especially for patients at high risk of rejection or graft failure.
ABSTRACT
Objective@#. Although gout is the most common form of inflammatory arthritis, data on gout prevalence and management are sparse, especially in Korean populations. This study reevaluated the most recent prevalence and incidence of gout values in Korean people to update the findings from our previous study in 2011. @*Methods@#. We used the National Health Insurance Service-National Health Information Database (NHIS-NHID) to identify patients diagnosed with gout in South Korea during 2002∼2015. We selected patients with gout as principal diagnosis or 1st∼4th additional diagnosis. @*Results@#. The prevalence of gout increased 5.17-fold, from 0.39% in 2002 to 2.01% in 2015. This increase occurred in all age groups, but was stronger in those aged 80 years or older, with a 13.1-fold increase from 2002 to 2015. The prevalence of gout increased in all regions of South Korea. The prevalence of the disease was also related to income levels: in 2015, medical insurance subscribers with the highest income were twice more likely to have gout than those in the lowest income bracket. By contrast, the prevalence of gout in medical benefit recipients was 5.58- and 5.25-times higher than that of the general population and of those in the highest income bracket, respectively. @*Conclusion@#. The prevalence of gout has increased rapidly, although the degree of increase varied according to sex, age, region, and income group. This study sheds some light on the current prevalence of gout among national insurance subscribers in Korea, and will help educate patients and medical staff on the management of gout.