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        사체 신이식에서 공여자의 상태가 이식신에 미치는 영향

        김삼정(Sam Jeoung Kim),박광재(Kwang Jae Park),이종수(Jong Soo Lee),양원석(Won Seok Yang),이상구(Sang Koo Lee),한덕종(Duck Jong Han),박정식(Jeong Sik Park),박수길(Su Kil Park) 대한내과학회 1997 대한내과학회지 Vol.53 No.4

        N/A Background: Kidney transplantation from cadaveric donor is increasing in KOREA. Knowledge of donor factors that can influence early graft function should be an important guideline in determining the suitability of a donor kidney for transplantation. Method: From June 1989 to August 1995, sixty patients with end-stage renal disease underwent kidney transplantation from thirty-two cadaver donors in Asan Medical Center. In this study, we reviewed the clinical characteristics of the cadaver donors including vital sign, urine output, serum creatinine, amounts of vasopressor needed, as well as the cause of brain death and evaluated the effect of these parameters on the early post-transplantation graft function (up to 6 months). Results: The data are given as median (range). The donors had been admitted for 40 hours (12-177) before nephrectomy. During admission, the lowest systolic blood pressure was 85mmHg (60-130). Platelet count was 112×10³/L (11-270×10³). Hour urine output was 447ml/h (212-937). These parameters did not have significant effects on the early post-transplantation graft function of our patients. Fifteen of thirty two donors had peak serum creatinine higher than 1.4mg/dl (mean 1.9㎎/dl, range 1.5-3.6㎎/dl) with serum creatinine 1.5㎎/dl (1.5-2.0) at the time of nephrectomy. The declining tendency and lowest level of serum creatinine after renal transplantation in patients who received kidneys from donor with peak serum creatinine higher than 1.4㎎/dl was not different from those in patients who received kidney with normal function. Conclusion: The transient hypotension or acute reversible mild to moderate deterioration of renal function in cadaver donor does not seem to have significant effect on the early post-transplantation graft function if underlying organic renal disease could be ruled out by careful history taking and clinical evaluation.

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