Effect of Donor Age on Graft Survival in Primary Penetrating Keratoplasty with Imported Donor Corneas

권현윤,현준영,전현선 대한안과학회 2020 Korean Journal of Ophthalmology Vol.34 No.1

Purpose: To investigate the influence of donor age on corneal graft survival following primary penetrating keratoplasty(PK) with imported donor corneas. Methods: The eyes of patients who underwent primary PK with imported donor corneas were classified retrospectivelyinto two groups according to a donor-age cutoff of 65 years. Primary outcome measures were rejection-free graft survival and graft survival. Cox proportional hazard regression analysis was used to assessthe factors affecting graft survival. Survival analysis was performed using the Kaplan-Meier method, whiledifferences between groups were examined using a log-rank test. A subgroup analysis of low- and high-riskeyes according to preoperative diagnosis was also performed. Results: A total of 140 eyes from 138 patients (age, 58 ± 18 years) were enrolled. Cox regression analysis revealedthat the donor age of 65 years or older group presented an increased risk of both graft rejection andfailure. Survival analysis revealed that rejection-free graft survival and graft survival rates were higher in eyesin the donor age of less than 65 years group. Finally, in the subgroup analysis, both rejection-free graft survivaland graft survival rates were significantly higher in the donor age of less than 65 years group than in the donorage of 65 years or older group, but only in the low-risk subgroup. Conclusions: Donor age may correlate with graft survival in primary PK performed with imported donor corneas. Donor age could be a considerable factor in primary PK with imported donor corneas, especially in preoperativelylow-risk patients.

신이식에서 이식신의 생존분석

오선미,김종학,황평주,구영선,강민규,나기량,김종섭,김성숙,이강욱,신영태,설종구,배진선,손기섭 충남대학교 의과대학 지역사회의학연구소 1997 충남의대잡지 Vol.24 No.2

To investigate the prognostic factors for the survival of transplanted kidney in patients with end-stage renal failure, 59 cases of renal transplantation from September 1986 to Feburary 1997 in Chungnam National University Hospital were analyzed retrospectively. The results were as follows: 1)The mean age of recipients was 33.8 years and that of doners was 38.9 years. The male to female ratio of recipients was 2.5:1, and that of donors was 1.03:1 2) Living related donore(LRD) were 79.6% and living non-related donors were 20.3%. The HLA-identical donors(ID) in LRD were 18.7% and HLA-haploidentical donors(HID) were 61.0%. In living non-related donors(LNRD), mean matched HLA-AB antigens were 1.56 and mean matched HLA-DR antigens were 0.56. 3) The average 5-year patient survival fate was 94%, and average 5-year graft survival rate was 70%. The 5-year graft survival fate of HLA-ID was 100%, and those HLA-HID and LNR were 70% and 36% respectively. 4) Total 33 episodes of acute rejection were found in 45.8% of transplanted patients. The number of acute rejection episode did not show significant difference between LRD and LNRD(P > 0.05). There was no significant difference in MLC between two groups(p > 0.05). 5) In comparison between the 18 patients who lost their graft function in 5 years and 17 patients who are maintaining graft function for more than 5 years, MLC was significantly lower in patients with functioning graft than of patients with non-functioning graft (p < 0.05). The number of rejection episode was also lower in patients with functioning graft than that of the patients with non-functioning graft(p < 0.05). However, there were no significant difference in recepient and donor age and history of pre-transplantation donor specific transfusion between two groups. With the results above, we can speculate that adequate donor selection according to good matched HLA typing and low MLC is very important for graft survival in renal transplantation. Prevention and treatment of acute rejection in renal transplantation is also na important factor for graft survival.

The impact of early and late acute rejection on graft survival in renal transplantation

( Eun Hee Koo ),( Hye Ryoun Jang ),( Jung Eun Lee ),( Jae Berm Park ),( Sung Joo Kim ),( Dae Joong Kim ),( Yoon Goo Kim ),( Ha Young Oh ),( Woo Seong Huh ) 대한신장학회 2015 Kidney Research and Clinical Practice Vol.34 No.3

Background: Advances in immunosuppression after kidney transplantation have decreased the influence of early acute rejection (EAR) on graft survival. Several studies have suggested that late acute rejection (LAR) has a poorer effect on longterm graft survival than EAR. We investigated whether the timing of acute rejection (AR) influences graft survival, and analyzed the risk factors for EAR and LAR. Methods: We performed a retrospective cohort study involving 709 patients who underwent kidney transplantation between 2000 and 2009 at the Samsung Medical Center, Seoul, Korea. Patients were divided into three groups: no AR, EAR, and LAR. EAR and LAR were defined as rejection before 1 year and after 1 year, respectively. Differences in graft survival between the three groups and risk factors of graft failure were analyzed. Results: Of the 709 patients, 198 (30%) had biopsy-proven AR [EAR¼152 patients (77%); LAR¼46 patients (23%)]. A total of 65 transplants were lost. The 5-year graft survival rates were 97%, 89%, and 85% for patients with no AR, EAR, and LAR, respectively. These differences were significant (Po0.001 for both by log-rank test). In time-dependent Cox regression analysis, EAR (hazards ratio, 3.37; 95% confidence interval, 1.90-5.99) and LAR (hazards ratio, 5.32; 95% confidence interval, 2.65- 10.69) were significantly related to graft failure. When we set LAR as standard and compared it with EAR, there was no statistical difference between EAR and LAR (P¼0.21). Conclusion: AR, regardless of its timing, significantly worsened graft survival. Treatments to reduce the incidence of AR and improve prognosis are needed.

Catholic Medical Center 에서의 신이식 22 년 - 생체 신이식 600 예의 결과 -

윤영석(Young Suk Yoon),김용수(Yong Soo Kim),방병기(Byung Kee Bang),윤재영(Jae Young Yoon),박용현(Yong Hyun Park),박철주(Chul Joo Park),고용복(Yong Bock Koh) 대한내과학회 1992 대한내과학회지 Vol.43 No.4

N/A Background: The results of twenty-two years of renal transplantation at the Catholic Medical Center have been reviewed to analyze data of transplants performed between March 1969 and March 1991, During these time our center has transplanted 578patients with 600allografts. We reviewed the factors which effect on the graft survival. Methods: The data have stratified to reflect differences in 1) immunosuppressants; 2) HLA matching; 3) donor sources; 4) graft number; 5) diabetics; 6) HBV status; 7) donor specific transfusion (DST); 8) number of pretransplant blood transfusion. Results: Overall actuarial 5-year patient and graft survivals were 77% and 66%, respectively. The actuarial 5-year graft survivals for the Aza-(n=141) and the CsA-(n=431) treated recipients were 51% and 76% respectively (p=0,00001), The actuarial 5-year graft survivals for the HLA-identical (n=4), haploidentical (n=85) and mismatched (n=26) groups were 75%, 54g and 3196 in the Aza group (p-0.0159); and HLA-identical (n=14) 77% haploidentical, (n=197) 77% 4mismatched groups (n=220) 81% in the CsA group (p= 0. 7432). The actuarial 5-year graft survivals according to related (n=294), non-related living donors (n=275) and cadavers (n =9) were 66%, 70% and 44%, respective- 1v (p=0.1182). The actuarial 5-year graft survivals for the first graft (n=578) and regraft (n=22) were 66% and 35% respectively (p=0.1751). The actuarial 5-year graft survivals for the diabetics (n=18) and non-diabetics (n=560) were 62% and 66%, respectively (p=0.5457). The actuarial 5-year graft survival for the HBV positive (n=47) and the negative (n =381) groups were 61% and 78%, respectively (p=0.1195). The actuarial 5-year graft survivals according to DST (n=123) and non-DST (n=314) in the CsA-treated recipients were 75% and 76%, respectively (p=0.6538); and the number of pretransplant blood transfusion, 0 (n=54), 1-4 (n=180) and over 5 (n=206) units groups were 77%, 71 and 73% respectively (p= 0.7929). Conclusion: The best graft survivals were obtained in recipients who received CsA for immunosuppression, and HLA-identical for the Aza group; but not in the HLA matching for the CsA group, donor sources, diabetics or not, HBV status, graft number, DST and number of pretransplant transfusion.

The Effect of Platelet-Rich Plasma on Survival of the Composite Graft and the Proper Time of Injection in a Rabbit Ear Composite Graft Model

Choi, Hyun Nam,Han, Yea Sik,Kim, Sin Rak,Kim, Han Kyeol,Kim, Hyun,Park, Jin Hyung Korean Society of Plastic and Reconstructive Surge 2014 Archives of Plastic Surgery Vol.41 No.6

Background Administration of growth factors has been associated with increased viability of composite grafts greater than 1-cm in diameter. Platelet-rich plasma (PRP) contains many of the growth factors studied. In this study, we evaluate the effect of PRP injection on composite graft viability and the proper time for injection. Methods A total of 24 New Zealand White rabbits were divided into four groups. Autologous PRP was injected into the recipient sites three days before grafting in group 1, on the day of grafting in group 2, and three days after grafting in group 3. Group 4 served as control without PRP administration. Auricular composite grafts of 3-cm diameter were harvested and grafted back into place after being rotated 180 degrees. Median graft viability and microvessel density were evaluated at day 21 of graft via macroscopic photographs and immunofluorescent staining, respectively. Results The median graft survival rate was 97.8% in group 1, 69.2% in group 2, 55.7% in group 3, and 40.8% in the control group. The median vessel counts were 34 (per ${\times}200$ HPF) in group 1, 24.5 in group 2, 19.5 in group 3, and 10.5 in the control group. Conclusions This study demonstrates that PRP administration is associated with increased composite graft viability. All experimental groups showed a significantly higher survival rate and microvessel density, compared with the control group. Pre-administration of PRP was followed by the highest graft survival rate and revascularization. PRP treatments are minimally invasive, fast, easily applicable, and inexpensive, and offer a potential clinical pathway to larger composite grafts.

The Results of Femorofemoral Bypass Using a Saphenous Vein Graft as an Alternative to PTFE Grafts

Gibeom Kwon,Ki Hyuk Park,Sang Gyu Kwak,Jaehoon Lee 대한혈관외과학회 2023 Vascular Specialist International Vol.39 No.1

Purpose: This study aimed to report the results of femorofemoral bypass (FFB) using a great saphenous vein (GSV) graft as an alternative to polytetrafluoroethylene (PTFE) grafts. Materials and Methods: From January 2012 to December 2021, 168 patients who underwent FFB (PTFE, 143; GSV, 25) were included. The patients’ demographic features and surgical intervention results were retrospectively reviewed. Results: There were no intergroup differences in patients’ demographic features. In GSV vs. PTFE grafts, the superficial femoral artery provided statistically significant inflow and outflow (P<0.001 for both), and redo bypass was more common (P=0.021). The mean follow-up duration was 24.7±2.3 months. The primary patency rates at 3 and 5 years were 84% and 74% for PTFE grafts and 82% and 70% for GSV grafts, respectively. There was no significant intergroup difference in primary patency (P=0.661) or clinically driven target lesion revascularization (CD-TLR)-free survival (P=0.758). Clinical characteristics, disease details, and procedures were analyzed as risk factors for graft occlusion. Multivariate analysis revealed that none of the factors was associated with an increased risk of FFB graft occlusion. Conclusion: FFB using PTFE or GSV grafts is a useful method with an approximately 70% 5-year primary patency rate. The GSV and PTFE grafts showed no difference in primary patency or CD-TLR–free survival during follow-up; however, FFB using GSV may be an option in selective situations.

혈행차단에 따른 두개골외판 이식의 생존 차이

박관규,박성근,한기환,강진성 大韓成形外科學會 1993 Archives of Plastic Surgery Vol.20 No.1

Difficulties arise in prediction of maintenance of the graft volume and viability of graft over time when a bone graft used for facial reconstruction. A bone-to-bone contact between the graft and the recipient bone is imporant for creeping substitution and survial of the recipient bone is important for creeping substitution and of the grafted bone. An adequate blood supply is also essential to ensure the survival of any live cells of the surface of the graft. Our study was designed to determine which one is an important factor viability of the grafted bone in Korean adult dogs : a bone-to-bone contact or overlying soft tissue. Blocks of outer table of the parietal bone were placed at the maxillae subperiostially in 4 different ways : bone-to-bone contact groups(groups Ⅰand Ⅱ)with placing a silicone membrane over the grafted bone and soft tissue contact groups(groups Ⅲand Ⅳ)with placing a silicone sheet between the grafted bone and the recipient. In groups Ⅰand Ⅲ, the cancellous surfaces of the parietal bone was placed on the recipient and the cortical surfaces were placed on the recipient in groups Ⅱ and Ⅳ. Caliper techniques were used to study the rates of volume maintenance of the grafts at 6, 12, and 20 weeks after bone grafting. The volumes of the living bone were quantified microscopically using a modified point-countiong technique. The volume is reduced in a similar rate with time in all groups. At 6 week, living bone cells increased in soft tissue contact groups Ⅲ and Ⅳ however, and increased in bone to bone contact groups Ⅰand Ⅱ at 12 and 20 weeks. there were osteoblastic proliferation and laminated mature bones in group Ⅰand Ⅱ. But osteoclasts and their associated osteolytic changes were still seen near the silicone membrane in group Ⅲ and Ⅳ, which may imply a continuing resorptive process with time. In summary, revascularization from the overlying soft tissue is important for the graft survival in early stage of the bone grafting while bone-to-bone contact may be essential in a later stage.

누드 마우스에서 인체 진피와 AlloDerm^�, 인공진피 Terudermis^� 이식의 생존에 관한 비교

박대숭,김한구,김승한,김승홍,이태진 大韓成形外科學會 2002 Archives of Plastic Surgery Vol.29 No.3

단일 센터의 소아 신이식 60례의 임상경험

이선연,한혜원,박영서,한덕종 대한소아과학회 2004 小兒科 Vol.47 No.1

Outcomes after liver transplantation in accordance with ABO compatibility: A systematic review and meta-analysis

Lee, Eung Chang,Kim, Seong Hoon,Park, Sang-Jae Baishideng Publishing Group Inc 2017 WORLD JOURNAL OF GASTROENTEROLOGY Vol.23 No.35

<P><B>AIM</B></P><P>To evaluate the differences in outcomes between ABO-incompatible (ABO-I) liver transplantation (LT) and ABO-compatible (ABO-C) LT.</P><P><B>METHODS</B></P><P>A systematic review and meta-analysis were performed by searching eligible articles published before No-vember 28, 2016 on MEDLINE (PubMed), EMBASE, and Cochrane databases. The primary endpoints were graft survival, patient survival, and ABO-I-related complications.</P><P><B>RESULTS</B></P><P>Twenty-one retrospective observational studies with a total of 8247 patients were included in this meta-analysis. Pooled results of patient survival for ABO-I LT were comparable to those for ABO-C LT. However, ABO-I LT showed a poorer graft survival than ABO-C LT (1-year: OR = 0.66, 95%CI: 0.57-0.76, <I>P</I> < 0.001; 3-year: OR = 0.74, 95% CI 0.64-0.85, <I>P</I> < 0.001; 5-yearr: OR =0.75, 95%CI: 0.66-0.86, <I>P</I> < 0.001). Furthermore, ABO-I LT was associated with more incidences of antibody-mediated rejection (OR = 74.21, 95%CI: 16.32- 337.45, <I>P</I> < 0.001), chronic rejection (OR =2.28, 95%CI: 1.00-5.22, <I>P</I> = 0.05), cytomegalovirus infection (OR = 2.64, 95%CI: 1.63-4.29, <I>P</I> < 0.001), overall biliary complication (OR = 1.52, 95%CI: 1.01-2.28, <I>P</I> = 0.04), and hepatic artery complication (OR = 4.17, 95%CI: 2.26-7.67, <I>P</I> < 0.001) than ABO-C LT. In subgroup analyses, ABO-I LT and ABO-C LT showed a comparable graft survival in pediatric patients and those using rituximab, and ABO-I LT showed an increased acute cellular rejection in cases involving deceased donor grafts.</P><P><B>CONCLUSION</B></P><P>Although patient survival in ABO-I LT was comparable to that in ABO-C LT, ABO-I LT was inferior to ABO-C LT in graft survival and several complications. Graft survival of ABO-I LT could be comparable to that of ABO-C LT in pediatric patients and those using rituximab.</P>