Korean Journal of Nephrology 1998;17(3):494-502.

신 이식 후 퇴원시 혈청 크레아티닌 치에 영향을 미치는 비면역학적 조건

배성화 , 임상우 , 정항재 , 박준범 , 도갑석 , 도준영 , 윤경우 , 서보양 , 박동춘

Abstract

There are two factors which influence the long term outcome of renal transplantation. One is the immunological factor such as HLA typing, the other is the nonimmunological factor such as physiologic match of the donor kidney to the recipient. We analyzed the relation between serum creatinine on the day of discharge which is known as a good predictor of long term graft survival and several nonimmunological factors influencing long term outcome of renal transplantation. One hundred fourteen renal transplanted patients in Yeungnam university hospital for 3 years after 1994 were included except the patients had experienced rapid deterioration of renal function like acute graft rejection. Several indices(KW/R.BSA, KW/R.BW, KW/ R,BMI, D.BSA/R.BSA, D.BW/R.BW: KW=kidney weight, R=recipient, D=donor, BSA=body surface area, BMI=body mass index, BW=body weight) re- presenting relative kidney size to recipient were significantly correlated with serum creatinine on the day of discharge(KW/R.BSA: r=-0.30, KW/R.BW: r=-0.35, KW/R.BMI:r=-0.41, D.BSA/R:BSA: r=-0.47, D.BW/R.BW: r=-0.44). Serum creatinine levels on the day of discharge were lower at the male kidney donated to female recipient than the female kidney donated to male recipient (0.89 vs. 1.22mg%, P<0.05). The age of donors had positive correlation with serum creatinine on the day of discharge (r=0.28). That was, when donor is more younger person, renal function after transplantation is better. But several indices by renal scan(effective renal plasma flow, perfusion index, peak renal uptake, Tl/2) done after transplantation, urine output of the next day after transplantaton, renal function of donor before transplantation(creatinine level) were not correlated with serum creatinine on the day of discharge. In conclusion, nonimmunological factor such as nephron mass size, age, gender should be considered when selecting renal donor, and the more actual, new criteria for kidney transplantation and long term prognosis should be worked out by further study.