단일기관에서 시행한 배우자간 신장이식의 결과

Abstract

The supply of deceased donors is limited in Korea and most of kidney transplantations are performed using living related or unrelated donors. In this study, we investigated the clinical characteristics and outcomes of spousal donor kidney transplantation at our center. Methods: From January 2000 to August 2008, we performed 909 cases of kidney transplantations. In this study, 475 one-haplomatch living-related donor (LRD) and 50 spousal donor kidney transplantations were retrospectively analyzed. We compared the outcomes of spousal donor group with those of one-haplomatch LRD group. We also compared the outcomes of husband-to wife with those of wife-to-husband subgroup. Results: The number of Human leukocyte antigen (HLA) mismatch was significantly larger in spousal group (3.3±1.2) than in LRD group (2.7±0.7). The proportion of tacrolimus use was higher in spousal group (72.0%) than in LRD group (26.6%). The incidence rate of delayed graft function was higher in spousal group (4.0%) than in LRD group (0.4%). There was no significant difference in the incidence of acute rejection between the two groups. Graft survival rates in spousal group (98.0% at 1 year and 91.5% at 5 year) were comparable to those in LRD group (99.6% at 1year and 98.7% at 5 year) (P=0.321). There were no significant differences in the incidence of acute rejection and graft survival rates between the subgroups (husband-to-wife vs. wife-to- husband). Conclusions: We achieved excellent outcomes by using spousal donor as an option to reduce the donor organ shortage