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신이식환자에서 이식과 환자의 생존에 영향을 끼치는 위험요인 분석

원문정보

Risk Factors Affecting the Graft and Patient Survival in Kidney Transplant Patients

김주영, 한덕종, 신혜영, 신완균, 오정미

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Purpose: To determine the short (1 year of transplant) and long-term (1-5 years of transplantation) risk factors affecting the graft and patient survival in kidney transplantation recipients. Methods: Records of 149 patients who received kidney transplantation in 1996 from Asan Medical Center were followed for 5 years retrospectively. Results: All patients initiated triple immunosuppressive therapy with cyclosporine, prednisone and azathioprine. One, two, three, four, five year patient and graft survival rates were 98.7%, 98.0%, 98.0%, 97.3%, 97.3%, and 96.6%, 95.2%, 94.6%, 92.5%, 91.8%, respectively. There were 30 cases of acute rejection (AR) and 6 cases of chronic rejection (CR) within months and months of transplantation, respectively. The risk factors for AR were donor's age older than 30 years (p=0.02) and cardiovascular disease (p=0.05). The risk factors for CR were AR (p=0.0169) and episode of complications (p=0.0330). Increasing period of dialysis (p=0.0473), episodes of AR (p<0.0001) and complication (p=0.0317) were significant factors for graft loss. Seven grafts were lost from noncompliance during 1-5 year period. The most com- mon cause of the graft loss for both periods was the graft rejection. The graft survival rate was significantly lower in patients with than without rejection episodes (77.4% vs. 90.0%, p=0.002). Conclusions: Survival rate of the graft with rejection was significantly lower. The risk factors affecting AR were donor's age older than 30years and CVD. AR and episode of complications within 1year were the risk factors for CR and graft loss.

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저자정보

  • 김주영 Joo Young Kim. 숙명여자대학교 임상약학대학원
  • 한덕종 Duck Jong Han. 울산대학교 의과대학 일반외과
  • 신혜영 Hae Young Shin. 서울아산병원 약재팀
  • 신완균 Whan Gyun Shin. 서울대학교 약학대학
  • 오정미 Jung Mi Oht. 서울대학교 약학대학

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