Clinical Experiences of 52 Cases Cadaveric Donor Kidney Transplantation

Choi, Ju Hyeon; Koh, Yang Seok; Choi, Soo Jin Na; Chung, Sang Young; Kim, Shin Kon

Abstract

PURPOSE: The organ procurement organization (OPO) and transplant coordinator were established in Chonnam National University Hospital in 1993 to promote organ donation and to manage organ procurement. At the same time, the first protocol and planning transplant was performed simultaneously. We performed this study to know the predicting factors and survival rate of cadaveric kidney transplantation.
METHODS
First cadaveric donor kidney transplantation was performed at May 1993 in Chonnam National University Hospital. Thereafter 52 cases of cadaveric kidney transplantation were performed using 28 cadaver donors till December 1999. The most frequent cause of brain death was head injury by traffic accident. Male to female donor ratio was 1.8 : 1. 52 recipients (29 males, 23 females), aged 20 to 65 years (median age 36 years) were the subjects of this study. The immunosuppressive regimens consisted of cyclosporin, mycophenolate mofetil, and prednisone. Acute rejection was treated with three consecutive bolus of 1.0 gram methylprednisolone or 5 mg/day for 10 days of OKT3. Three HLA mismatchs were 7 cases (13.5%) and six mismatches were 6 cases (11.5%). There were 2 cases of multiple renal arteries.
RESULTS
There was no primary non functioning graft. In the first 7 post operative days, urine amount less than 4,000 mL per day was noted in 29 patients (55.8%) and serum creatinine over 1.5mg/dL was noted in 13 patients (25%). No significant proteinuria and hematuria was observed. Postoperative medical complications were occured in 12 patients (23.1%) and minor surgical complications in 3 patients (5.8 %). One patient was performed reoperation because of urinary leakage. CMV infections were noted in 15 patients (28.8%). Acute rejection episodes were 17 cases (32.7%). We lost 4 grafts within 1 year. The major cause of graft loss was patient death. Recipient age was significant risk variable for graft and patient survival in multivariate analysis (P=0.012). one and five year graft survival rates were 92.15%.
CONCLUSION
To achive better results, continued attention should be paid to the cadaveric donor organ procurement.