The Korean Journal of Medicine

The Korean Association of Internal Medicine (대한내과학회)
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Clinical Outcomes between Living Related and Living Unrelated Kidney Transplantation in ABO-Incompatible Kidney Transplant Recipients

ABO 혈액형 부적합 신장이식 환자에서 혈연 간 신장이식과 비혈연 간 신장이식의 성적 비교

  • Park, Wooyeong (Department of Internal Medicine, Keimyung University School of Medicine) ;
  • Han, Seungyeup (Department of Internal Medicine, Keimyung University School of Medicine) ;
  • Hwang, Eunah (Department of Internal Medicine, Keimyung University School of Medicine) ;
  • Park, Sungbae (Department of Internal Medicine, Keimyung University School of Medicine) ;
  • Park, Uijun (Department of Surgery, Keimyung University School of Medicine) ;
  • Kim, Hyungtae (Department of Surgery, Keimyung University School of Medicine) ;
  • Cho, Wonhyun (Department of Surgery, Keimyung University School of Medicine)
  • 박우영 (계명대학교 의과대학 내과학교실) ;
  • 한승엽 (계명대학교 의과대학 내과학교실) ;
  • 황은아 (계명대학교 의과대학 내과학교실) ;
  • 박성배 (계명대학교 의과대학 내과학교실) ;
  • 박의준 (계명대학교 의과대학 외과학교실) ;
  • 김형태 (계명대학교 의과대학 외과학교실) ;
  • 조원현 (계명대학교 의과대학 외과학교실)
  • Received : 2014.04.13
  • Accepted : 2014.05.15
  • Published : 2014.12.01
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Abstract

Background/Aims: Kidney transplantation (KT) is the best treatment for end-stage renal disease patients. Although previous studies have demonstrated that the clinical outcome following living related (LR) KT is better than that following unrelated (LUR) KT in ABO-compatible KT recipients, recent studies showed no differences in clinical outcomes between the two treatments. In this study, we compared the clinical outcomes of LR and LUR KT in ABO-incompatible KT recipients. Methods: From January 2011 to August 2013, 19 cases of ABO-incompatible KT were analyzed retrospectively. Eight kidneys (7 cases of parent-offspring and 1 case of siblings, Group 1) were donated from living-related donors and 11 (all spousal donors, Group 2) from living-unrelated donors. We investigated patient survival, graft survival, acute rejection, graft function, and complications. Results: On Kaplan-Meier analysis, patient and graft survival during follow-up were 87.5% and 87.5% in Group 1; both were 100% in Group 2. Acute rejection, graft function, and medical and surgical complications were not significantly different between the two groups. Conclusions: The short-term clinical outcomes between LR and LUR KT in ABO-incompatible KT recipients were equivalent. Most domestic cases of LUR KT are from spousal donors and the spousal donor will be a major donor in ABO-incompatible KT patients.

목적: 신장이식은 말기 신부전 환자의 치료에 있어 가장 효과적인 신대체 요법이다. 과거 ABO 혈액형 적합 신장이식에서 혈연 공여자 신장이식이 비혈연 공여자 신장이식보다 성적이 좋다고 보고 되었으나 최근에는 성적에 차이가 없다고 보고되고 있다. ABO 혈액형 부적합 신장이식에서 혈연간 신장이식과 비혈연 간 신장이식 성적을 비교하였다. 방법: 2011년 1월부터 2013년 8월까지 ABO 혈액형 부적합 신장이식 19예가 후향적으로 분석되었다. 혈연 간 신장이식은 8예(부모-자식 간 7예, 형제간 1예), 비혈연 간 신장이식은 11예(배우자 간 11예)였다. ABO 혈액형 부적합 신장이식에서 혈연 간 신장이식군과 비혈연 간 신장이식군의 환자 및 이식 신장 생존율, 급성 거부반응, 이식 신장 기능, 합병증에 대해 조사하였다. 결과: Kaplan-Meier 분석에 따라 혈연 간 신장이식군에서 추적 기간 동안 환자 생존율 및 이식 신장 생존율은 각각 87.5%, 87.5%였고 비혈연 간 신장이식군에서 모두 100%였다. 급성 거부반응, 이식 신장 기능, 내외과적 합병증은 양군간에 의미 있는 차이가 없었다. 결론: ABO 혈액형 부적합 신장이식에서 혈연 간 신장이식과 비혈연 간 신장이식 단기 성적의 차이가 없었다. 국내 비혈연 간 신장이식의 대부분은 배우자 간 신장이식으로 배우자는 ABO 혈액형 부적합 신장이식의 주요 공여자가 될 수 있을 것이다.

Keywords

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