신장이식에 있어서 공여자와 수혜자의 성별이 예후에 미치는 영향

Abstract

The role of the donor and recipient gender have been a controversial point in the outcome of renal transplantation and the pathophysiologic mechanisms are not understood clearly. In order to evaluate the effect of gender on the renal graft survival, we reviewed our 400 consecutive living donor renal transplantation. The patients were divided into four groups, Group 1; male donor and male recipient(n=152), Group 2; female donor and male recipient(n=61), Group 3; male donor and female recipient(n=135), and Group 4; female donor and female recipient(n=52). To estimate the transplant outcome between the groups, we analyzed patient and graft survival, acute tubular necrosis, BUN, creatinine and rejection episode for maximum 5 years after transplantation. The level of BUN(34.7 26.4, 19.8 6.4, 30.5 14.6, 23.1 10.5 in group 1,2,3,4 respectively) and serum creatinine(2.62 2.3, 1.48 1.1, 2.24 1.2, 1.65 0.9 in group 1,2,3,4 respectively) were higher in male recipient groups regardless of donor gender. However, donor and recipient gender had no influence on post-graft blood pressure and acute tubular necrosis(p＞0.05). Acute rejection episode was predominent at female donor graft than male donor graft(36.4% vs 30.1%). The 5 year graft survival in group 1,2,3,4 were 67.8, 67.2, 60.1, 72.7% and patient survival were 76.9, 75.6, 72.6, 80.5% in their orders. These results suggest that donor and recipient gender might play a role in the outcome of renal transplantation. The mechanism of these results must be analyzed by further evaluation using larger patient group.