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KMID : 0365719960120010042
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Journal of Pusan Surgical Society
1996 Volume.12 No. 1 p.42 ~ p.52
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Living-Donor Renal Transplantations, Analysis of Risk Factors Influencing the Outcome of 190 Cases
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Lee Hyeong-Keol
Jeong Joon-Heon
Kong Jin-Min
Kim Byung-Chang
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Abstract
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We have performed 190 renal transplantations from August 1990 to June 1996. No cadaveric donor was used and all except one were first grafts. We conducted a clinical analysis, especially concerning the factors affecting acute rejection and graft
function at 1 year.
The results were as follows :
1)) The mean ages of donor and recipient were 35.3 years and 37.4 years respectively. The ratio of male to female was 1.4 : 1 and 15 : 1, respectively.
2) One hundred and six cases (55.8%) were living unrelated donors and 84 cases (44.2%) were living related donors.
3) One hundred sixty-six potential recipients were given 3 donor specific transfusions (DST), started about 5 weeks prior to transplantation with cyclosporin coverage. Six of these patients (3.6%) developed sensitization by DST that precluded the subsequent transplantation and remaining 160 patients received the kidneys from the blood donors. Another 28 recipients were given DST 24 hours prior to operation.
4) Most of initial acute rejection episodes (71 episodes, 95%) appeared within the first month of posttransplantation.
5) We analyzed the possible factors affecting the incidence of acute refection. Donor age and HLA incompatibility were significant statistically (p<0.05).
6) Multiple regression analysis showed that a number of acute rejection episodes (p<0.001) was the only independent risk factor for the graft function at 1 year.
7) Overall graft and patient survival rate were 97.2% and 98.6% at 1 year, 95.4% and 95.5% at 3 years.
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