Korean Journal of Nephrology 1991;10(3):401-411.

신장이식 24예의 임상적 고찰

신승훈 , 정민수 , 이순구 , 이정호 , 이강욱 , 신영태 , 손기섭 , 윤완희 , 설종구

Abstract

24 Cases of renal transplantation from September 1986 to March 1991 in Chungnam National University Hospital were analyzed. The results were as follows: 1) The mean age of recipients was 30.6 years and that of donors was 39.2 years. The sex distributions of recipi- ents were 19 cases in male and 5 cases in female and those of donors were 9 cases in male and 15 cases in female. 2) Among 24 patients, 17 patients received kidney from living related donors (LRD) and 7 patients from living nonrelated donors (LNRD). 3) The results of HLA typing in 17 LRD were HLA identical in 3 case and HLA haploidentical in 14 cases. In 10 LNRD, the mean matched number of HLA-AB antigens were 1.14±0.90 and those of HLA-DR antigens were 0.67±0.52. 4) The mean percentage of MLC in HLA identical LRD, HLA haploidentical LRD and LNRD were 3.0±5.0%, 38.9±18.7% and 62.6±33.2% respectively. 5) The overall patient survival rate was 100% up to postoperative 54 months and graft survival rate was 91.1%, 85.7% and 77.2% at 1, 2 and 4 years respectively. 6) 10 acute rejection episodes were occurred in 8 recipi- ents (33.3%) and 8 episodes were occurred within 1 year. In two patients graft losses were developed despite of methyl-prednisolone pulse treatment. The incidence of acute rejection in LRD and LNRD were 29.4% and 42.9%. Respectively but there was no statistical significance (p>0.05). Also there was no statistical significance between incidence of acute rejection and MLC, DST or number of pretransplant transfusion. 7) The medical complications were presented with infections (urinary tract infection, pulmonary-renal tuberculosis, HBV reactivation and peritonitis), deep vein thrombosis and hyperuricemia. The complications associated with immunosuppressive agent were as fol- lows: Complications of cyclosporine were hyperkalemia, nephropathy, hepatotoxicity, tremor and hirsuitism; those of imuran were hepatotoxicity and leukopenia; those of prednisolone were glycosuria and acne. The surgical complications were renal artery stenosis, stricuture of ureterovesical junction, perforation of renal artery, urinoma, lymphocele, wound infection and ureter obstruction due to blood clot. It was thought that these medical and surgical complications has adverse effect on function of transplant kidney.