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        신이식 100예에서 이식신의 예후에 영향을 미치는 인자

        편도철(Do Chul Pyun),정인권(In Kweon Jung),임창범(Chang Bum Lim),양영란(Young Ran Yang),임정식(Jeong Sik Lim),김종진(Jong Jin Kim),하봉준(Bong Jun Ha),김홍기(Hong Khee Kim),이시래(Si Rhae Lee),이승도(Sung Do Lee),류현열(Hyun Yul Rhew 대한내과학회 1989 대한내과학회지 Vol.37 No.5

        N/A It has been reported that many factors other than HLA and the mode of immunosuppression influence the results of renal transplantation. The factors are constantly changing with the advances in surgical techniques and introduction of Cyclosporin-A s-A), etc. We analyzed the possible prognostic factors in 100 cases of renal allograft which were performed by the transplantation team of Kosin Medical College from Dec. 1984 to Aug. 1988. Detailed results are presented for the several factors as follows: 1) HLA and the mode of immunosuppression. Excluding 9cases of graft failure due to non-immunological causes, the actuarial graft survival in 3 years was 100% in the E3LA-II) group, 95.1% in the HLA-HID group and 84.6% in the LUR group. In the HLA-HID group, the 3 year graft survival (3YGS) was 96.8% in the Cs A+P treated group and 93.3% in the Aza+P treated group, and the difference in these 2 groups was not significant statistically (p>0.1). Numbers of patients with serum creatinine equal or above 2 mg/dl were 5 of 17cases (29.4%) in the Aza+P treated HLA-HID group, and 8 of 47cases (17.1%) in the Cs-A+P treated HLA-HID group, but the difference was not significant statistically (p>0.1). 2) Pretransplant transfusions. Twenty-seven cases which were transfused with more than 10 units of packed red cells were 100% in 3YGS and the other cases were 97.8% in 3YGS, And there was no significant difference between Aza+P and Cs A+P treated HLA-HID groups in relation to transfusion (p>0.1), 3) Donor and recipient age. The 3YGS in donors older than 50 years and in those 50 years old and under were 93.796 and 94.895, respectively, The percentages of cases with serum creatinine equal or above 2mg/dl were 26. 5% in the older than 50 years group and 12.3% in the other group, but the difference was not significant statistically (p>0.1). Thirteen cases older than 60 years were 10096 in 3YGS. Recipient age had no significant effect on 3YGS between the older than 50 years group and the other group (p>0.1). 4) Donor and recipient sex. The 3YGS was highest (100%) in the male to male group and lowest (87.5%) in the male to female group, but the difference was not significant in these 2 groups (p>0.1). 5) Minor ABO incompatibility. Seventeen cases with minor ABO incompatibility were 100% in 3YGS, and in remaining compatible 74 cases, the 3YGS was 93.4% and there was no significant difference (p>0.1). In summary, the 3YGS was higherst in the HLA-ID group, and there was no signifcant difference in 3YGS between Aza+P and Cs A+P treated HLA-HID groups. And the elder (more than 50 years or 60 years) donor group did not show lower 3YGS than the younger age group despite somewhat worse graft function. There appears to be a minimal effect with mismatch of sex and minor ABO incompatibility. And the fact that there is no significant relation between pretransplant transfusion and 3YGS seems to be due to DST, which was done in all cases except HLA-ID and 2cases of the HLA-HID group.

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