|
| 소아 신장이식 56예의 임상적 고찰 |
| 전우성 , 권민중 , 배기수 , 이재승 , 김병길 , 오창권 , 김유선 , 박기일 |
|
|
| Abstract |
|
We compared graft survival (GS) by several variables to find risk factors in pediatric (PD) renal transplants (RT), and checked the height (HT) promotion in successful PD RT based on 52 PD RT. In 31 patients (PT), original disease was identified: reflux nephropathy (10), Alport syndrome (7), FSGS (5), MPGN (3), congenital hypo/dysplastic kidney (2), IgA nephropathy (2), chronic GN (4). Either trans(14)-or extra(38)-peritoneal a pproach was employed according to the size or weight of PT. One case of perinephric hematoma requiring reoperative intervention occurred. Two PT were dead of sepsis. Currently, 50 PT are alive with functioning graft in 45. Cause of graft failure (7) was chronic rejection (CR, 3), poor compliance (2), patient death (2). One PT with CR had a 2 nd graft. GS at 1 and 5 year (GS-1 & GS-5) was 96.0 and 75.5%. There was no significant difference of GS by the source of donor, degree of HLA match, episode of acute rejection. ABO matching was a signifi- cant risk factor affecting GS: GS-5 in identical ABO pair was 91.0% comparing with 41.0% in compatible pairs (p=0.0083). Of 17 PT with complete record, 6(35.3%) showed improvement in standard deviation score of HT, and 3(17.6%) showed improvement in HT age. Conclusion: GS in PD PT is excellent with GS-5 over 75%. ABO matching to be a significant risk factor affecting graft survival. RT may be of benefit in growing children both in aiding psychological problems and in promoting height growth. Therefore, vigorous attempts should be made to perform renal transplantation in the early stages of ESRD. The importance of early diagnosis & proper management of refiux ne- phropathy should not be overlooked in PD PT with recurrent urinary tract infection. |
|
PDF Links
Download Citation
