41 cadaveric kidney transplantations performed in the Asan Medical Center for the past 5 and half years, from
Feburary 1989 to August 1994 were analyzed retrospectively.
While one year graft survival(81.7%) was compatible with the western countries, we are at tempting to improve the graft survival by looking at the multi-factors affecting the early graft function and long term survival.
@ES The results were as follows;
@EN Causes of brain death were trauma(50.0%), cerebrovascular accident(31.8%), brain tumor with subdural hematoma(9.2%), and others in descending order of frequency. Among 22 cadaveric donors, 9 cases(42.9%), and others in descending order of
frequency.
Among 22 cadaeric donors, 9 cases(42.9%) were solitary kidney donors and the others were multiorgan donors, such as kidney-heart(4), kidney-liver(3), kidney-pancreas(2), kidney-liver-pancreas(2), kidney-liver-heart(1), and
kidney-liver-pancreas-heart(1).
Graft survival was 81.7% after one year and 78.5% after three years. Patient survival was 94.4% after one year and 94.4% after three years(Kaplan-Meier inethod).
Causes of graft failure were acute rejection(4.9%), accelerated rejection(2.4%), primary nonfunction with superimposed acute rejetion(7.3%) and chronic rejection(4.9%). Factors affecting graft survival were donor's age, donor's general condition,
cold
ischemic time, serum creatinine level at postoperative day one, at discharge and at one month and presence of acute rejection.
We conclude that every effort must be made to improve the graft survival by proper donor selection, stabilization of donor condition, proper organ preservation and shortening of cold ischemic time in order to decrease the chance of delayed
function
or
primary nonfunction, and proper use of immunosuppressant for prophylaxis and treatment of acute rejection.
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