Korean J Transplant.  2022 Nov;36(Supple 1):S173. 10.4285/ATW2022.F-2999.

A nationwide study of regional preference and graft survival of kidney transplantation in South Korea: patterns of centralization in capital area

• Jang Y
• Park H
• Park SJ
• Pyun S
• Cho HR

• KMID: 2535689
• DOI: http://doi.org/10.4285/ATW2022.F-2999

Abstract

Background
While the extent of the kidney transplant (KT) field is increasing in South Korea, a problem of centralization of med-ical care into the capital city is rising. This study is focused on a pattern of regional preference and differences in graft survival rates of KTs by region in South Korea, based on the national database.
Methods
We identified KT patients between 2002 and 2017 from Korean National Healthcare Insurance Service (NHIS) data-base. Patients actual residency, the city that KT was performed, and post-KT dialysis to identify graft failure were collected. The final collected data was verified by comparison to the KT from the Ulsan University Hospital, and KOTRY (Korean Organ Trans-plantation Registry) 2017 report.
Results
Of 20,978 KTs, 60.48% (12,688 cases) was counted in Seoul, and 39.52% (8,290 cases) was counted in non-Seoul areas. Overall graft survival was 81.52% (median, 57 months), and overall patient survival was 83.80% (median, 61 months). The overall graft and patient survival of Seoul versus non-Seoul major cities were 84.14%, 85.31% for Seoul and 80.65%, 83.33% for non-Seoul respectively (P=0.0371 and 0.2259). Of 4,167 KTs from 2002 to 2007, the 10-year graft survival rate and patient sur-vival rate were 89.3% and 90.26% respectively.
Conclusions
We recognized the regional preference from the number of KTs in South Korea. KTs were highly concentrated in the capital city and it is due to a significant proportion of non-residents. There was no statistically significant difference in KT graft and patient survival rates by region.