공여자와 수혜자의 성별, 연령, 체질량지수 조합에 따른 생체 신이식의 이식신 생존율의 장기 성적에 대한 연구

Abstract

Background: Despite significant advances in immunosuppression, supportive therapies, and operative skills, several factors still compromise long-term graft survival of patients who undergo renal transplantation. This study was designed to evaluate the risk factors influencing graft outcomes of living donor renal transplantation. We matched the recipient and donor age, gender, and body mass index (BMI). Methods: A total of 527 living renal transplantations were evaluated. The patients were divided into matching groups by donor and recipient age; group 1 (50≤/; 2, 50≤/<50; 3, <50/50≤; 4, <50/<50), gender (A, female/female; B, female/male; C, male/female; D, male/male), and BMI ratio (recipient/donor) (I, <0.8; II, 0.8≤/<1.3; III, 1.3≤). We compared 1, 3, 5, and 10 year graft survival and analyzed the donor and recipient variables of age, HLA matching, and acute rejection. Results: The risk factors affecting long-term graft survival were recipient gender, acute rejection rate, and HLA-AB matching. In the groups divided according to donor and recipient age, no statistical difference was observed among the groups, but the 3–5 yr graft survival of group 1 (94.1/86.9%) was much higher than group 2 (86.5/75.6%). In the groups divided according to donor and recipient gender, graft survival in group C was higher than that in the other groups. No statistical difference in acute rejection or graft survival were observed in the groups with different BMI ratios. Conclusions: Meticulous preoperative donor and recipient matching for living renal transplantation may improve graft survival and expand the donor and recipient pool.