|
신장이식 100예에 대한 임상적 고찰 |
임종식 , 도준영 , 윤경우 , 서보양 , 권굉보 , 김영수 , 박동춘 , 정승필 |
|
Abstract |
100 cases of renal trsnsplantation were performed at YeungNam University Hospital from January 1984 to July 1993. We have analy@zed the complication and outcome of these patient in conection with various factors. The results follows:, 1) The most common cause of CRF was unknown. Known underlying diseases were chronic glomerulo- nephritis, hypertension, nephrotic syndrome, rapidly progressive glumerulonephritis, polycystic kidney dis- ease, vesicoureteral reflux and DM in order of fre- quency. 2) The mean age of recipients was 35. The male to female ratio was 2.12:1 3) Among 100 patients, 37 patients received kid- ney from living related donor(LRD), 63 from living non related donor(NRD). 4) Graft losses after transplantation were 17 cases. Among 17 cases, 2 cases were due to acute re- jection, 9 cases due to chronic rejection, 6 cases due to death of patients. 5) Acute rejection was observed in 6 patients, all of the acute rejection were occurred in living non re- lated transplantation. 4 Cases were recovered. 6) Chronic rejection was observed in 9 patients, more in living non related transplantation(11%) than in living related transplantation(5%). 7) Among 100 patients, 6 patients were died. The major cause of death was pneumonia. The other causes were cerebrovascular accident, hepatic failure, varix bleeding due to liver cirrhosis. 8) The most common complication after transplan- tation was infection due to use of immunosupressive agent. Side effects of immunosupressive agent were gum hyperplasia, erythrocytosis, alopecia, hirsutism, nephrotoxicity, DM, avascular necrosis of femoral head. 9) The graft survival rate at 3 years was 94 % in living related transplantation, 66% in living non-re- lated transplantation.(p<0.05) In living non related transplantation, there was no difference in graft sur- vival rate according to HLA compatability. In living related transplantation, the graft survival rate at 3 yesrs was 62.5% in immuran(Aza) group, 100% in cyclosporin A(CyA) group.(p<0.05) In living non related transplantation, there was no difference in graft survival rate according to immunosupressive agent. 10) Donor specific transfusion(DST) was per- formed in 5 patients. The graft survival rate at 3 years in DST group was higher than non DST group, but there was no significant difference between two groups. |
|