신장이식 500예의 임상적 고찰

Abstract

Purpose: Five hundreds of renal transplantation were performed in the our institute from November, 1982 to April, 2000. During this period, there were two big changes of immunosuppressive regimen. These are introduction of cyclosporin microemulsion formula (Neoral®) in April, 1994 and mycophenolate mofetil (MMF) in April, 1997. So, the result of our 500 consecutive renal transplantation was analysed and compared according to the regimen. Methods: We analysed the result of our 500 renal transplantation by retrospective chart review. And we compared the result according to the regimen. Results: Mean age of recipients were 33.6 years and male to female ratio was 2.14 ： 1. There was 18 retransplantation and 18 pediatric transplantation. Overall 1 year, 3 year and 5 year graft survial was 95,38%, 81.65% and 70.56%. And the patient survival was 96.78%, 92.31% and 89.46%, respectively. Before the introduction of Neoral (n=285), acute rejection during first 6 months (AR6mo) was 0.52 ± 1.09 and serum creatinine level at 12 months post-tranplant (Cr12mo) was 1.954± 1.488 and 1 year (1YSR), 3 year (3YSR) and 5 year (5YSR) graft survival was 93.64%, 77.66% and 65.32%. After introduction of Neoraland before MMF (n=134), AR6mo and Cr12mo was 0.62±1.83 and 1.625±1.203 and 1YSR, 3YSR and 5YSR was 96.27%, 87.03% and 79.97%, respectively. After addition of MMF (n=74), AR6mo and Cr12mo was 0.19±0.39 and 1.434± 0.773 and 1YSR and 3 YSR was 95.93% and 95.93%. Because of short term follow up for the last group, long term survival rate was indefinable. Conclusion: With advancement of immunosuppressive agents and accumulation of clinical experiences, short term result of the kidney transplantation was improved. Further evaluation of long term result is needed.