Cyclosporine 사용 이후의 소아 신이식과그 예후인자에 관한 분석

Abstract

A total of 82 pediatric renal transplants treated with cyclosporine and low dose prednisolone as the main immunosuppressive agents were used as the subjects of this study to find the risk factors whitch might influence the pediatric renal allograft survival in a single center from Feb. 1984 to Mar. 1996. The mean age of the recipients was 14.7 years ranging from ages 3.9 to 19.9. There were 19 cases of graft loss, and 3 recipient death. The major causes of the graft %loss were acute and/or chronic rejection, poor compliance and patient's death. The 1-, 3- and 5-year graft survival were 94.9%, 86.2% and 70.% respectively. The original renal deseases of ESRD were FSGS (14 cases), chronic pyelone- phropathy and VUR (11 cases) and IgA nephropathy (8 cases) in order frequency. The significant risk factors for the outcome were the ABO incompa- tibility (ABO identical 89.6% vs compatible 26.9%, P=0.001) and development of more than 1 episode of acute rejection within 1 year (P=0.002) and after 1 year(P=0.004). Other factors such as recipient's age, donor-recipient relationship and type and duration of dialysis modalities before trasplantation (P>0.05), In conclusion, for the successful outcome of pedia- tric renal transplantation, strict ABO matching and development and application of more effective immu- nosuppressive agents such as mycophenolate or FK- 506 to combat the acute and/or chronic rejection is required in near future.