• Childhood Kidney Diseases
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• v.4 no.1
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• pp.84-91
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• 2000

Purpose: To improve the recovery of growth deficit after renal transplantation in children, we analysed the factors affecting height growth after renal transplantation. Methods: We reviewed medical records of fifty-six children in whom height data were available for three years after transplantation. All height data were converted into Z-scores. We analyzed the effects of sex, age at transplantation, cumulative mean steroid dose for 3 years, serum creatinine levels, height at transplantation, donor source and history of prior dialysis on patients' z-scores and delta Zs. Results: The Z-scores at transplantation were lower in patients of younger age (P=0.007). When baseline Z-scores were lower, the delta Zs were higher (P<0.01), but the Z-scores after transplantation were still lower (P<0.001). According to the analysis of the partial correlation coefficients, Z-scores and delta Zs at 1 year after transplantation were higher in groups of younger age and of lower steroid dosages (P<0.05). The delta Zs at 6 month and 1 year after transplantation were lower in the group with abnormally higher serum creatinine (P<0.05). There was no difference in Z-scores between groups of different genders, donor sources, and histories of previous dialysis. Conclusion: The children of younger age, on lower steroid dosage, with less growth retardation at transplantation, and with normal graft function had better height growth recoveries after renal transplantation.

• Childhood Kidney Diseases
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• v.6 no.2
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• pp.131-141
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• 2002

Purpose : Renal transplantation which allows children normal growth and development and a return to normal life. is now proven to be the best modality for children with ESRD Up to Recently, the number of renal transplantations in Asia has rapidly increased and the outcome has also improved. This investigation was planned to estimate the current status of pediatric renal transplantation in Asia and to find the keys for better improvement of outcome in pediatric renal allograft in Asian countries. Material and methods : The participating countries and institutions for this investigation were China, Hong Kong, India, Indonesia, Japan, Malaysia, Pakistan, Philippines, Singapore, Thailand, Korea, KSPN (Korean Society of Pediatric Nephrology), KONOS (Korean Network for Organ Sharing). Results : Many countries in Asia still do not have a well organized nation wide renal transplantation registration system independently in the pediatric field. So it's very difficult to evaluate the real state of pediatric transplantation among Asian countries. According to the estimation with fragmented data from each countries, in the front running countries of pediatric renal transplantation in Asia, about 40 or more transplants were performed in each country per year and the five year actuarial renal allograft survival was around 80% which is similar to that of western countries. But there were large gaps among the behind groups. Conclusion : Vigorous attempts to perform renal transplantation for children especially younger than 5 years old would be encouraged as well as organ donation from brain dead donor and non heart beating cadaveric donor also should be activated to cope effectively with the shortage of living donor supply. Large number of recent reports shows the favorable outcome of pre-emptive renal transplantation, we should make more efforts toward pre-emptive renal transplantation. First of all, in order to improve the outcome and to narrow the gap between Asian countries in pediatric renal transplantation, effective and continuous efforts to establish nationwide pediatric renal transplantation registration program as well as official, nation-to-nation data sharing program should be needed.

• The Korean Journal of Nuclear Medicine
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• v.35 no.4
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• pp.251-257
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• 2001

Purpose: We investigated the possibility of early postoperative Tc-99m DTPA scintigraphy in predicting long-term renal transplant survival. Materials and Methods: 64 living donor (LD) grafts were divided into two groups according to the graft function on early post-operative renal scintigraphy. Survival analysis was performed using Kaplan-Meier method and Cox proportional hazard model. Chi-square test was performed to evaluate the difference in the frequency of acute rejection. Results: Cumulative renal transplant survival was decreased in 11 patients with abnormal renal scintigraphy, but it was not statistically significant. Decreased graft function on early post-operative renal scintigraphy was not a predictor of long-term graft survival. The frequency of acute rejection was higher in abnormal scintigraphy group, and the difference was statistically significant. Conclusion: Decreased graft function on early post-operative renal scintigraphy has no direct effect on long-term renal transplant survival in LD transplantation. But it may have an indirect elect through increasing the frequency of acute rejection.

• Childhood Kidney Diseases
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• v.6 no.1
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• pp.120-122
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• 2002

A 9-year-old boy of B blood group with end-stage renal disease due to IgA nephropathy received group O kidney transplantation from his father On day 9, he developed intravascular hemolysis, and anti-B autoantibody formation was confirmed. We diagnosed as immune hemolytic anemia due to passenger lymphocyte from donor, and cyclosporine withdrawl was done. Anemia resolved spontaneously, but on day 18, graft dysfunction developed, and graft biopsy revealed acute allograft rejection. Although hemolysis due to autoantibody is very rare and often mild, and the role of hemoglobinuria on acute rejection in this case is not certain, we recommend consideration of aggressive management on severe hemolysis after minor mismatched kidney transplantation. (J Korean Soc Pediatr Nephrol 2002 ; 6 : 120-2)

• Childhood Kidney Diseases
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• v.11 no.2
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• pp.152-160
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• 2007

Twenty-six renal allograft biopsies which showed acute rejection and had renal capsule and medulla in the same specimen were selected in order to compare the severity of acute rejection between superficial cortex, deep cortex and medulla. Disregarding the mid cortical region, the superficial cortex was considered as being one-third of the distance from the renal capsule to the medulla and the deep cortex as being that one-third of the cortex which was adjacent to the medulla. Using semiquantitative histologic analysis the following parameters were compared in superficial cortex, deep cortex, and medulla: interstitial inflammation, edema, tubulitis, and acute tubulointerstitial rejection grade. Also, the presence of lymphocyte activation and polymorphonuclear leukocytes was evaluated. Significantly greater histologic changes of acute rejection were found in the deep cortex vs. supeficial cortex for the following parameters: interstitial inflammation(P=0.013), edema (P=0.023) and tubulointerstitial rejection grade(P=0.016). These findings support the view that biopsies in which deep cortex is not included may result in underestimation of the severity of renal allograft rejection.

• Journal of Embryo Transfer
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• v.8 no.1
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• pp.9-12
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• 1993

포유동물의 초기 발생단계에서 핵의 분화와 전능성을 규명하고 제2세대 핵이시 기법을 개발하고자 생쥐를 모델로 하여 공핵란은 2-세포기에 있는 수정란의 핵을 사용하였으며, 수핵란은 zygote 및 2-세포기에 있는 수정란을 탈핵하여 제2세대 핵이식을 실시하여 electrofusion system으로 핵융합을 실시하고 cloned embryo를 작출하여 이를 24-48시간동안 체외에서 배양을 시킨 다음 위임신이 유기된 수란생쥐의 난관에 체내 이식을 실시하여 개체로의 발생 여부 등을 조사하였다. 핵이식후의 융합율은 zygote 및 2-세포기의 수정란을 수핵란으로 사용하였을 때 각각 84.7 및 84.0%으로서 차이가 없었으며, 제1세대의 86.8 마ㅊ 85.4%로서 세대간에 차이가 없었다. 4-세포기 이상으로 발달한 제2세대 핵이식 수정란의 체외배양율은 수핵란을 zygote 및 2-세포기 수정란을 사용하였을때 각각 36.2 및 43.7%로서 제1세대 핵이식의 44.3 및 50.4% 보다는 다소 낮았다. 제2세대 핵이식 수정라늘 위임신이 유기된 수란생쥐의 난관에 이식을 실시하여 얻은 산자생산율은 수핵란을 zygote 및 2-세포기 수정란을 사용하였을때 각각 23.0 및 25.0%로서 모두 25마리의 산자를 생산하였다.

• The Monthly Diabetes
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• s.159
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• pp.12-16
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• 2003

• Childhood Kidney Diseases
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• v.14 no.2
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• pp.223-229
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• 2010

Percutaneous transluminal renal angioplasty (PTRA) is the current treatment of choice for renal artery revascularization, but renal autotransplantation has been an alternative treatment for complex cases. Here we report a 14-year-old boy with severe hypertension successfully treated with PTRA and renal autotransplantation. Doppler ultrasonography and computed tomography (CT) angiography revealed slight narrowing in the right renal artery ostium and complete obstruction in the left renal artery ostium with multiple collaterals. PTRA with stent insertion was performed for the treatment of the right renal artery, but it was impossible for the left renal artery due to the total obstruction. Therefore, left nephrectomy for autotransplantation was done with the peritoneal approach and the left kidney was autotransplanted to the ipsilateral iliac fossa. Postoperatively, Doppler ultrasonography and mercapto-acetyl-triglycine (MAG-3) renogram were performed, which showed normal renal artery blood flow and kidney function. Blood pressure was normalized and anti-hypertensive drugs were gradually tapered. Fibromuscular dysplasia was suspected to be responsible for the renal artery stenosis based on clinical aspects. In conclusion, renal autotransplantation is also a good treatment option for children with severe renovascular hypertension when endovascular treatment has failed or is not possible.

• Childhood Kidney Diseases
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• v.14 no.1
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• pp.100-104
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• 2010

We report on two children with a high risk of recurrent focal segmental glomerulosclerosis (FSGS) after renal transplantation that could be effectively prevented by prophylactic administration of cyclosporine combined with preemptive plasmapheresis prior to renal transplantation.

• The Korean Journal of Nuclear Medicine
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• v.34 no.6
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• pp.497-507
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• 2000

Purpose: We have examined the utility of $^{99m}Tc$-MAG3 perfusion indices for assessing renal graft function in early post-transplantation period. Materials and Methods: Our study included 80 renal transplant recipients (48 men and 32 women, mean age: 40.3 years). Diagnosis was based on biopsy, laboratory data and clinical course. Renal scintigraphy (RS) was obtained using 100 MBq of $^{99m}Tc$-MAG3 from 11 days to 23 days of kidney transplantation. We measured 5 indices in whole-kidney (WK) and cortical (C) renograms; Hilson's perfusion index (PI), transplant perfusion index (TP) and transplant function index (TF) as perfusion parameter, and the time to peak activity (Tmax) and the ratio of renal counts at 20 min to that at 3 min (K20/3) as functional parameter. Results: The diagnoses at the day of RS were normal graft (NG) in 44, acute rejection (AR) in 14, acute tubular necrosis (ATN) in 10, and Cyclosporine A nephrotoxicity (CsA) in 12. TP and TF were significantly decreased in AR, ATN and CsA, compared to those in NG. K20/3 of AR and ATN wore significantly greater than that of NG. WK-Tmax of AR was significantly longer than that of NG. K20/3 of AR and C-K20/3 of ATN were significantly prolonged relative to those of CsA. There were no statistically significant perfusion indices among complication groups. Conclusion: TP and TF reflecting microperfusion and initial tubular extraction are reliable in assessing graft function. However, it is required to correlate perfusion indices with functional indices and clinical course in differentiating from one another among complication groups.