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KMID : 0941820060160010014
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Korean Journal of Clinical Pharmacy
2006 Volume.16 No. 1 p.14 ~ p.22
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Risk Factors Affecting the Graft and Patient Survival in Kidney Transplant Patients
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Kim Joo-Young
Han Duck-Jong
Shin Hye-Young
Shin Wan-Gyoon
Oh Jung-Mi
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Abstract
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Purpose: To determine the short (1 year of transplant ) and long-term (1-5 years of transplantation) fisk factors affecting the graft and patient survival in kidney transplantation recipients.
Methods: Records of 149 patients who received kidney transplantation in 1996 from Asan Medical Center were followed for 5 years retrospectively.
Results: All patients initiated triple immunosuppressive therapy with cyclosporine, prednisone and azathioprine. One, two, three, four, five year patient and graft survival rates were 98.7%, 98.0%, 98.0%, 97.3%, 97.3%, and 96.6%, 95.2%, 94.6%, 92.5%, 91.8%, respectively. There were 30 cases of acute rejection (AR) and 6 cases of chronic rejection (CR) within 2.1±3.2 months and 42.1±13.2 months of transplantation, respectively. The risk factors for AR were donor’s age older than 30 years (p=0.02) and cardiovascular disease (p=0.05). the fisk factors for CR were AR (p=0.0169) and episode of complications (p=0.0330). Increasing period of dialysis (p=0.0473), episodes of AR (p<0.0001) and complication (p=0.0317) were significant factors for graft loss. Seven grafts were lost from noncompliance during 1-5 year period. The most common cause of the graft loss for both periods was the graft rejection. The graft survival rate was significantly lower in patients with than without rejection episodes (77.4% vs. 90.0%, p=0.002).
Conclusions: Survival rate of the graft with rejection was significantly lower. The risk factors affecting AR were donor’s age older than 30 years and CVD. AR and episode of complications within 1 year were the risk factors for CR and graft loss.
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KEYWORD
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kidney transplantation, outcomes, graft rejection, risk factors, patient survival
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