• Korean Journal of Radiology
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• 제20권6호
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• pp.894-908
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• 2019

Kidney transplantation is the treatment of choice for patients with end-stage renal disease, as it extends survival and increases quality of life in these patients. However, chronic allograft injury continues to be a major problem, and leads to eventual graft loss. Early detection of allograft injury is essential for guiding appropriate intervention to delay or prevent irreversible damage. Several advanced MRI techniques can offer some important information regarding functional changes such as perfusion, diffusion, structural complexity, as well as oxygenation and fibrosis. This review highlights the potential of multiparametric MRI for noninvasive and comprehensive assessment of renal allograft injury.

• Tuberculosis and Respiratory Diseases
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• 제82권4호
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• pp.348-356
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• 2019

Background: Recently, the number of lung transplants in South Korea has increased. However, the long-term outcome data is limited. In this study, we aimed to investigate the long-term outcomes of adult lung transplantation recipients. Methods: Among the patients that underwent lung transplantation at a tertiary referral center in South Korea between 2008 and 2017, adults patient who underwent deceased-donor lung transplantation with available follow-up data were enrolled. Their medical records were retrospectively reviewed. Results: Through eligibility screening, we identified 60 adult patients that underwent lung (n=51) or heart-lung transplantation (n=9) during the observation period. Idiopathic pulmonary fibrosis (46.7%, 28/60) was the most frequent cause of lung transplantation. For all the 60 patients, the median follow-up duration for post-transplantation was 2.6 years (range, 0.01-7.6). During the post-transplantation follow-up period, 19 patients (31.7%) died at a median duration of 194 days. The survival rates were 75.5%, 67.6%, and 61.8% at 1 year, 3 years, and 5 years, respectively. Out of the 60 patients, 8 (13.3%) were diagnosed with chronic lung allograft dysfunction (CLAD), after a mean duration of $3.3{\pm}2.8years$ post-transplantation. The CLAD development rate was 0%, 17.7%, and 25.8% at 1 year, 3 years, and 5 years, respectively. The most common newly developed post-transplantation comorbidity was the chronic kidney disease (CKD; 54.0%), followed by diabetes mellitus (25.9%). Conclusion: Among the adult lung transplantation recipients at a South Korea tertiary referral center, the long-term survival rates were favorable. The proportion of patients who developed CLAD was not substantial. CKD was the most common post-transplantation comorbidity.

• 대한이식학회지
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• 제28권3호
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• pp.135-143
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• 2014

Background: Kidney injury molecule-1 (KIM-1) is known as a good ancillary marker of acute kidney injury (AKI) and its expression has also been observed in acute rejection and chronic graft dysfunction. We tested usefulness of KIM-1 as an indicator of acute and chronic renal graft injury by correlating KIM-1 expression with renal graft function and histology. Methods: A total of 133 zero-time biopsies and 42 follow-up biopsies obtained within 1 year posttransplantation were selected. Renal tubular KIM-1 staining was graded semiquantitatively from 0 to 3 and the extent of staining was expressed as the ratio of KIM-1 positive/CD10 positive proximal tubules using Image J program. Results: KIM-1 was positive in 39.8% of zero-time biopsies. KIM-1 positive cases were predominantly male and had received grafts from donors with older age, deceased donors, and poor renal function at the time of donation, compared with KIM-1 negative cases. KIM-1 expression showed correlation with delayed graft function and acute tubular necrosis. In comparison of KIM-1 expression between stable grafts (n=23) and grafts with dysfunction (n=19) at the time of repeated biopsy, the intensity/extent of KIM-1 staining and renal histology at zero-time did not differ significantly between the two groups. Histologically, KIM-1 expression was significantly increased with both acute and chronic changes of glomeruli, tubules and interstitium, peritubular capillaritis, and arteriolar hyalinosis. Conclusions: KIM-1 can be used as an ancillary marker of AKI and a nonspecific indicator of acute inflammation and tubulointerstitial fibrosis. However, KIM-1 expression at zero-time is not suitable for prediction of long-term graft dysfunction.

• Journal of Chest Surgery
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• 제37권8호
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• pp.623-631
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• 2004

배경: 대망의 가장 중요한 성질 중 하나인 혈관 형성 촉진 기능을 이용하여 초냉동 보관된 기관 이식편의 대망 내 이식이 기관 이식편의 생육성이나 혈관 형성에 미치는 영향을 연구하고자 한다. 대상 및 방법: 8주령의 Sprague Dawley rat 수컷의 초냉동 보관된 기관 이식편을 백서의 복강 내 대망에 이식하였다. 연구군은 냉동 보관기간과 대망 내 이식기간에 따라 4개의 군으로 분류하였다(n=52). 이식된 기관 이식편을 획득하여 기관 평활근 및 주변 결합 조직의 섬유화 및 염증 정도, 기관 연골의 석회화 정도, 기관 내 상피세포의 변화 및 연골간 간격에서의 혈관 형성 정도 등을 검사하였다. 결과: 기관 평활근의 염증 정도는 냉동 보관기간이나 대망 내 이식기간에 따라 유의한 차이를 보이지 않았고, 기관 연골의 석회화 정도는 냉동 보관기간과 상관없이 대부분 심하게 진행되어 있었다. 혈관 형성은 기관 이식편의 양끝뿐만 아니라 중간 부위에서도 충분히 이루어져 있었다. 결론: 초냉동 보관된 백서의 장분절 기관 이식편을 2주간 대망 내 이식을 시행한 결과 기관 이식편의 조직 생육성이 적절히 유지되면서 새로운 혈관이 형성되었다. 향후 동종 기관 이식 시 초냉동 보관된 기관 이식편을 대망 내 이식하여 새로운 혈관이 형성된 후 단계적으로 기관 이식을 시행하는 데 도움이 될 수 있다고 생각한다.