|
KMID : 0371320010600030281
|
|
Journal of the Korean Surgical Society
2001 Volume.60 No. 3 p.281 ~ p.287
|
|
|
The Analysis of Risk Factors of Donor Affecting the Graft Survival in Cadaveric Kidney Transplantation
|
|
Kong Pil-Sung
Choi In-Seok
Lee Kwang-Woong
Kim Sung-Ju
Song Geon-Do
Lee Suk-Koo
Kim Yong-Il
Lee Byung-Boong
Cho Jae-Won
|
|
|
Abstract
|
|
|
Purpose: The supply of donor organs does not meet the demand of transplantation. To find a possible way of expanding the donor pool, we have evaluated the risk factors of cadaveric donors that influence the graft survival.
Methods: Between Feb. 1995 and Dec. 1999, we performed 200 cases of cadaveric kidney transplantation. The graft survival rates in 1 yr, 2 yr, & 3 yr are 93.0%, 91.1%, & 89.9%, respectively. We defined the marginal donor as a donor who possesses one of the risk factors of donor age ≥50, or ≤5 year old (n=18), ICU stay ≥10 days (n=46), history of hypertension (n=30), CPR ≥20 min (n=7), prolonged hypotension (SBP ≤80 mmHg, over 6 hr) (n=40), high dose inotropic support (dopamine ≥20μg/kg/min, or dobutamine ≥15μg/kg/min) (n=78), serum creatinine level ≥2.5 mg/dl (n=16), or cold ischemic time ≥12 hr (n=34). We compared graft survival rates between the marginal donor group and the non-marginal donor group, and analyzed risk factors affecting graft survival by univariate and multivariate methods.
Results: CPR ≥20 min (71.5%, 71.5%, - vs 93.8%, 91.8%, 90.6%, p=0.027), prolonged hypotension (85.0%, 85.0%, 80.3% vs 95.0%, 92.6%, 92.6%, p=0.028) and serum creatinine ≥2.5 mg/dl (75.0%, 75.0%, 75.0% vs 94.6%, 92.4%, 91.0%, p=0.001) affect graft survival in univariate analysis. There is, However, no risk factor that affects graft survival in multivariate analysis.
Conclusion: We can increase the supply of donor organs for kidney transplantation by the selective use of high-risk cadaver donor. However, a prospective randomized study including recipient factors is needed to define the acceptable conditions better.
|
|
|
KEYWORD
|
|
|
Cadaveric kidney transplantation, Risk factors, Graft survival
|
|
|
FullTexts / Linksout information
|
|
  
|
|
|
Listed journal information
|
|
  
|
|