• Title/Summary/Keyword: 신장공여자

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Allograft Immune Reaction of Kidney Transp lantation Part 2. Immunosuppression and Methods to Assess Alloimmunity (신이식 후 면역반응의 이해 2부 이식면역검사와 면역억제제)

  • Kang, Hee-Gyung
    • Childhood Kidney Diseases
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    • v.12 no.2
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    • pp.133-142
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    • 2008
  • For solid organ transplant, ABO blood type of donor and recipient should be compatible in principle. Recent improvement of immunosuppressant made HLA typing not so important while no-mismatch transplant still shows the longest graft survival. PRA(panel reactive antibody) test is to screen and identify recipients with HLA sensitization. When solid organ transplant is scheduled, cross-match test of donor cell and recipient serum should be performed and positive result of cross-match prohibits transplantation. Donor specific antibody(DSA) test can predict the severity of recipient immune reaction against donor organ. Today's mainstay of allograft immunosuppressant regimen is triple therapy of steroid, calcineurin inhibitor(cyclosporine, tacrolimus), azathioprine or mycophenolate mofetil(MMF). Antibody induction using Thymoglobulin or anti-IL-2 receptor antibody(basiliximab or daclizumab) is frequently practiced as well.

Health Status and Health-promoting Lifestyle for Living Donors after Kidney Donation Through Survey (설문조사를 통한 생체 신장 공여자의 기증 후 건강상태와 건강증진 생활방식)

  • Nam, Min Kyung;Lee, Doo In;Kwon, Oh Jung
    • Korean Journal of Transplantation
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    • v.28 no.3
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    • pp.144-153
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    • 2014
  • Background: Normal renal function and health have been recognized as important factors in living donors after kidney donation. The purpose of this study was to evaluate the health status and health-promoting lifestyle in living donors after kidney donation. Methods: A total of 678 living-kidney donors were counted in our center from January 1990 to December 2011. Only 84 donors agreed to participate in the survey by telephone. We received consent for participation in our survey from 48 donors (57.1%). Data were collected from May to August 2013 using donor characteristics, health status, and Health Promoting Lifestyle Profile I (HPLP-I). Results: The donors were predominantly female (62.5%) and the average age was 48.9±11.8 years, and the average period after nephrectomy was 9.7±5.7 years. The characteristics of donors included ideal body weight (37.5%), overweight (37.5%) in body mass index, and good health status (81.3%). Most donors underwent an annual medical check-up (56.2%), no health problem (81.3%), and no disease (64.6%). However, one patient was treated with dialysis for renal failure due to diabetes. The total average score for HPLP-I was 128.3±13.9. Higher than average scores (116.3±19.1) were observed for the general middle-aged woman. There were statistically significant differences in self-realization and nutrition in subsection of HPLP-I. Self-realization showed a higher score for Christian (F=2.743, P=0.041) and good health (F=3.389, P=0.017). Nutrition showed a higher score for overweight, obesity (F=6.783, P=0.000), and older than 60 (F=3.854, P=0.009). Conclusions: Most living kidney donors were healthy after their donation and had relatively high scores for health-promoting lifestyle. However, one patient had a serious health problem. In addition, younger, longer period after donation, and the rare health examination of donors showed a lower health-promoting lifestyle. Designed and continuous health-care management after transplantation is needed for kidney donors.

Study on Glomerular Filtration Rate comparison according to renal depth measurement of kidney donors (신 공여자에서 신장 깊이 측정에 따른 사구체여과율의 비교에 관한 고찰)

  • Lee, Han Wool;Park, Min Soo;Kang, Chun Goo;Cho, Seok Won;Kim, Joo Yeon;Kwon, O Jun;Lim, Han Sang;Kim, Jae Sam;Park, Hoon-Hee
    • The Korean Journal of Nuclear Medicine Technology
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    • v.18 no.2
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    • pp.48-56
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    • 2014
  • Purpose $^{99m}Tc$-DTPA renal scintigraphy serves as a key indicator to measure a kidney donor's Glomerular Filtration Rate (GFR) and determine the possibility of kidney transplant. The Gates method utilized to measure GFR considers 3 variables of renal depth, injection dose, and net kidney counts. In this research, we seek to compare changes in kidney donors' GFR according to renal depth measurement methods of the 3 variables. Materials and Methods We investigated 32 kidney donors who had visited the hospital from October, 2013 to March, 2014 and received abdominal CT and $^{99m}Tc$-DTPA GFR examination. With the cross-section image of the CT and the lateral image from a gamma camera, we measured the renal depth and compared with renal depth calculation equations-Tonnesen, Taylor, and Itoh methods. Renal depth-specific GFR was calculated by using Xeleris Ver. 2.1220 of GE. Then the results were compared with MDRD (Modification of Diet Renal Disease) GFRs based on serum creatinine level. Results The renal depths measured based on the CT and gamma camera images showed high correlation. Tonessen equation gave the lowest GFR value while the value calculated by using the renal depth of CT image was the highest with a 16.62% gap. MDRD GFR showed no statistically significant difference among values calculated through Taylor, Itoh, CT and gamma camera renal depth application (P>0.05), but exhibited a statistically significant change in the value based on Tonnesen equation (P<0.05). Conclusion This research has found that, in GFR evaluation in kidney donors by utilizing $^{99m}Tc$-DTPA, Tonnesen equation-based Gates method underestimated the value than the MDRD GFR. Therefore, if a MDRD GFR value shows a huge difference from the actual examination value, using an image-based renal depth measurement, instead of Tonnesen equation applied to Gates method, is expected to give an accurate GFR value to kidney donors.

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Effect of Various Cross-linking Types on the Physical Properties in Carbon Black-Filled Natural Rubber Compound (천연고무 배합물에서 가교형태 변화가 물성에 미치는 영향)

  • Park, Byung-Ho;Jung, Il-Gouen;Park, Sung-Soo
    • Polymer(Korea)
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    • v.25 no.1
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    • pp.63-70
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    • 2001
  • The objective of this study was to investigate the effect of cure type on the processing and physical properties under conditions of similar stress-strain properties. On the carbon black filled natural rubber(NR) based compound, the induction time decreased, but the cure rate became fast with increasing loading of sulfur donor agent. Tensile strength was little affected on the curing type. However, elongation generally decreased with increasing accelerator. Effect of cure type on the blow-out properties was followings: CV

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Analysis of Factors Affecting Height Growth After Renal Transplantation in Children (소아 신이식 후의 키 성장에 영향을 미치는 인자들에 대한 연구)

  • Lee Joo Hoon;Lee Byong Sop;Kang Hee-Gyung;Hahn Hyewon;Lee Jun Ho;Ha Il Soo;Cheong Hae Il;Choi Yong;Kim Sang Joon
    • 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.

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Increased Frequency of Apolipoprotein E4 Genotype in Childhood Minimal Change Nephrotic Syndrome (MCNS) (소아 미세변화 신증후군 환자에서 Apolipoprotein E4 유전자형에 관한 연구)

  • Kim Sung-Do;Bae Young-Min;Cho Byoung-Soo;Cho Yoe-Won;Kim Il-Soo
    • Childhood Kidney Diseases
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    • v.5 no.2
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    • pp.87-99
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    • 2001
  • Purpose: We studied to find out apo-E genotype polymorphism in minimal change nephrotic syndrome(MCNS) and IgA nephropathy(IgAN) and to determine the relationship between apo-E genotype and clinical course of MCNS. Materials and Method: 43 MCNS patients and 15 IgAN patients were examined for apo-E polymorphism. 50 healthy blood donors were examined for apo-E genotype as control. Genomic DNA was prepared front peripheral blood leukocytes according to standard procedures. Results: As compared with control group, e4 allele frequency was significantly increased in MCNS (p<0.01). However, in IgAN e2 allele frequency, however, was 2.6 times higher than normal control (P<0.01). The frequency of e4 allele of frequent relapser group was 4.6 times higher than normal control and was 2 times higher than infrequent relapser group. Conclusion: We think that apo-E typing might be one of the parameters, which should be considered to predict the course of MCNS in children. MCNS with risky HLA profile and E4/4 genotype could indicate the need for a longer steroid administration. And apo-E genotype needs to be considered for the evaluation of therapeutic responses to other drugs. (J, Korean Soc Pediatr Nephrol 2001 ; 5 : 87-99)

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