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KMID : 0616619950010010439
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Journal of Soonchunhyang Medical College
1995 Volume.1 No. 1 p.439 ~ p.448
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The Influence of HLA-A, B, DR mismatches on pancreas graft survival in bladder-drained simultaneous pancreas-kidney transplants
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Song, Young Sun
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Abstract
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Multiple factors can influence the outcome of pancreas transplantation. One of these is HLA matching, but the effect is less clear. The purpose of this study was to determine the influence of HLA mismatching on the pancreas graft survival rates in recipients of cadaver(CAD) bladder-drained(BD) sii ?ultaneous pancreas-kideny(SPK) transplants. In addition other factors including number of transplant, preservation time, recipient age effecting pancreas graft survival rates were also analyzed.
We studied 191 whole organ SPK transplants from cadaver donor in type 1 diabetic patients performed at the University of Minnesota between July 9, 1966 and December 31, 1993. The mean age at the time of transplantation was 38(range 22-57) years. 159 were in patients <45 years old. 175 were primary transplants. Preservation time were <12 hours in 19, 12-23 hours in 141, 24-29 hours in 28 and >30 hours in 3. HLA matching data for the A locus were available in 164 and for the B locus in 163 and for the DR locus in 159, and for A, B, DR loci in 152. All patients received quadruple immunosuppression : anti-T- cell induction therapy for 10 to 14 days, azathioprine, cyclosporine, and prednisone.
The results were as follows:
1. Pancreas graft survival rates according to degree of HLA A, B and DR mismatches in CAD BD SPK transplants were not significantly different.
2. The overall Cox regression analysis of graft survival showed a significant impact of donor age(RR=1.025) and recipient age(RR=1.034). But retransplants, presevation time, number of HLA mismatches did not influence pancreas graft survival.
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KEYWORD
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