Influence of Donor’s Renal Function on the Outcome of Living Kidney Transplantation: 10-Year Follow-up
정현철, 이성호, 양대열, 김성용, 김하영, 이삼열, 김정원, 이원기,
소속 상세정보
정현철 ( Jeong Hyun-Cheol )
Hallym University College of Medicine Department of Urology
이성호 ( Lee Seong-Ho )
Hallym University College of Medicine Department of Urology
양대열 ( Yang Dae-Yul )
Hallym University College of Medicine Department of Urology
김성용 ( Kim Sung-Yong )
Hallym University College of Medicine Department of Urology
김하영 ( Kim Ha-Young )
Hallym University College of Medicine Department of Urology
이삼열 ( Lee Sam-Uel )
Hallym University College of Medicine Department of Surgery
김정원 ( Kim Jeong-Won )
Hallym University College of Medicine Department of Pathology
이원기 ( Lee Won-Ki )
Hallym University College of Medicine Department of Urology
KMID : 0358320120530020126
Abstract
Purpose: With the improved surgical techniques and immunosuppression available today, conventional prognostic factors have taken on less significance. Accordingly, the native renal function of the donor is thought to be more important. Thus, we analyzed the prognostic significance of the donor’s renal function as assessed by 24-hour urine creatinine clearance on kidney graft survival for 10 years after living kidney transplantation.
Materials and Methods: From January 1998 to July 2000, 71 living kidney transplantations were performed at a single institution. From among these, 68 recipients were followed for more than 6 months and were included in the present analysis. We analyzed kidney graft survival according to clinical parameters of the donor and the recipient.
Results: Mean follow-up duration of recipients after living kidney transplantation was 115.0±39.4 months (range, 10 to 157 months), and 31 recipients (45.6%) experienced kidney graft loss during this time period. Estimated mean kidney graft survival time was 131.8±6.2 months, and 5-year and 10-year kidney graft survival rates were estimated as 88.2% and 61.0%, respectively. Donor’s mean 24-hour urine creatinine clearance (Ccr) before kidney transplantation was 122.8±21.2 ml/min/1.73 m2 (range, 70.1 to 186.6 ml/min/1.73 m2). The 10-year kidney graft survival rates for cases stratified by a donor’s Ccr lower and higher than 120 ml/min/1.73 m2 were 39.0% and 67.2%, respectively (p=0.005). In univariate and multivariate analysis, donor’s Ccr was retained as an independent prognostic factor of kidney graft survival (p=0.001 and 0.005, respectively).
Conclusions: Donor’s 24-hour urine Ccr before living kidney transplantation was an independent prognostic factor of kidney graft survival. Therefore, it should be considered before living kidney transplantation.
키워드
Creatinine; Kidney transplantation; Survival
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