No abstract available.
Allografts* ; Cyclosporine* ; Humans

In Korea, 9,396 kidney transplantations were performed by 44 centers until the end of 1998. Fourteen major centers performed about 76% of kidney transplantations (7,123) and they participated in the post-marketing surveillance (PMS) program. Patients on cyclosporine (Sandimmun(R)or Sandimmun Neoral(R)) with functioning graft were enrolled for PMS study and the numbers were 4,544. Surveillance started at the time of conversion from conventional cyclosporine (c-CsA) to microemulsion cyclosporine (me-CsA) in 2,899 recipients (conversion group) or at any post-transplant (post-Tx) period in 1,645 recipients who had received me-CsA since their kidney transplantations (new group). The starting point of PMS (mean) was post-Tx 52.5 months in conversion group and 4.8 months in new group. During the follow-up period (25.1 10.5 months), 339 recipients (7.5%) discontinued me-CsA due to graft failure (n=179, 52.8%), patient death (n=72, 21.2%), conversion of main immunosuppressive agent (n=43, 12.7%) or follow-up loss (n=45, 13.3%). The graft survival rate of conversion and new group was 95.8% and 98.3% in post-PMS 12 months, respectively. The incidence of acute rejection was 25.4% within 1 year after transplantation in new group. The incidence of chronic rejection for post-PMS 1 year was 6.7% in conversion group and 1.2% in new group. During the study period, there were no significant interval changes of serum creatinine and BUN in recipients with functioning graft on both groups (P>0.05). In conversion group, there was a trend of daily CsA dose decrement, but this is not significant statistically. The incidence of metabolic or other complications in recipients was 13.5% and they were; hypertension (6.2%), cardiovascular accident (0.6%), cerebrovascular accident (0.2%), post-transplant diabetes (1.5%) and avascular necrosis (0.5%). Infectious complication occurred in 4.5% recipients and biopsy proven CsA toxicity was found in 1.5% of recipients. The incidence of patient with abnormal liver function test (more than twice of effects after conversion. There was an acceptable range of acute and chronic rejection, graft survival rate, CsA-related side effects and medical events in Korean renal transplant recipients in new transplant group.
Biopsy ; Creatinine ; Cyclosporine* ; Follow-Up Studies ; Graft Rejection ; Graft Survival ; Humans ; Hypertension ; Incidence ; Kidney Transplantation ; Korea ; Liver Function Tests ; Necrosis ; Stroke ; Survival Rate ; Transplantation* ; Transplants

No abstract available.
Humans ; Microcomputers* ; Survival Analysis*

Nocardia is a significant opportunistic pathogen in patients with compromised immunity. The authors isolated N. asteroides from an abscess of the axilla and from respiratory specimens of a renal allograft patient with pneumonia. Direct smear of the sputum and bronchial washing specimens showed many branching, filamentous forms which were gram-positive and acid fast. Culture yielded slow growing small white colonies which became orange on further incubation. Aerial hyphae were produced. Identification of the species was based on typical cultural and biochemical tests. The isolate was susceptible to amikacin, minocycline and rifamipicin. The patient became afebrile after 8 weeks of treatment with cotrimoxazole and brief treatment with other antimicrobial agents.
Adult ; Human ; Kidney Transplantation* ; Lung Diseases/etiology* ; Male ; Nocardia Infections/etiology* ; Nocardia asteroides/isolation & purification

No abstract available.
Aged* ; Humans ; Tissue Donors*

No abstract available.
Aged* ; Humans ; Tissue Donors*

No abstract available.
Allografts* ; Kidney Transplantation* ; Risk Factors*

No abstract available.
Humans ; Lymphocytes* ; Stomach Neoplasms* ; Stomach*

Diagnostic ability of duplex Doppler ultrasonography reling on resistive index is limited when clinical symptoms and signs of rejection are subtle or renal dysfunction is caused by other conditions such as urinary tract infection. To investigate the significance in the changes of renal pelvis, a combined analysis of resistive index and ultrasonographic findings in cases of renal pelvis dilatation and mucosal thickening was undertaken. A mean resistive index was calculated from Doppler measurements of the main, segmental and interlobar arteries. The cause of mucosal thickening was retrospectively analysed using the clinical and laboratory findings. Twenty three cases of renal pelvis dilatation and 17 cases of mucosal thickening were found in a total of 159 renal transplantation cases. In 14 of the 23 cases with renal pelvis dilatation, renal function was normal and their mean resistive index was 0.64±0.04. Pelvis and ureter dilatation caused by ureteral stenosis or compression was demonstrated in 6 cases and their mean resistive index(0.72±0.05)was increased. Mucosal thickening of renal pelvis was found in 7 of 32 cases with acute rejection and in 2 of 13 cases with chronic rejection, but their mean resistive index was not different from that of the cases without pelvic mucosal changes Three cases of acute rejection associated with urinary tract infection and 2 cases of chronic rejection in whom resistive indices were indeterminate, but mucosal thickening of the renal pelvis was prominent at ultrasonography. In renal transplant patients having indeterminate resistive index and mucosal thickening of the renal pelvis, ultrasonographic features must be correlated with the clinical and laboratory findings for an accurate diagnosis and treatment of renal dysfunction.
Arteries ; Constriction, Pathologic ; Diagnosis ; Dilatation* ; Humans ; Kidney Pelvis ; Kidney Transplantation ; Kidney* ; Pelvis* ; Retrospective Studies ; Ultrasonography ; Ultrasonography, Doppler, Duplex ; Ureter ; Urinary Tract Infections

Several parameters of cell-mediated immunity thirty-eight patients with end stage chronic renal failure were measured including total lymphyocytes, B-and T-lymphocytes, T-cell subsets and the mitogenic reponse to PHA and Con A at three different times; before dialysis, 3 months and 12 months after dialysis treatment. There were no significant differences in the absolute numbers of peripheral leukocytes between each patient and the control group. But the absolute numbers of lymphocytes of each patient group were significantly reduced compared to the control group (p< 0.01). The proportion of peripheral blood active T cells and helper T cells was significantly reduced both in the predialysis uremic and dialysis populations compared to the control group, although the helper/suppressor(OKT4/OKT8) ratio was not different between each patient and the control group except for a lower ratio in the hemodialysis 12 month follow-up group (HD 12M). With respect m the PHA and Con A stimulation tests, the stimulation indices of the predialysis and hemodialysis groups were significantly lower than those of the control group. However, patients on continuous ambulatory peritoneal dialysis (CAPD) exhibited a normal mitogenic response and a lower suppressor cell removal index compared to the patients on hemodialysis, suggesting an improved cell-mediated immunity in the patients undergoing CAPD.
Adult ; Aged ; B-Lymphocytes/*immunology ; Comparative Study ; Human ; In Vitro ; Kidney Failure, Chronic/*immunology/therapy ; Lectins/pharmacology ; Leukocyte Count ; Lymphocyte Activation/drug effects ; Middle Age ; Peritoneal Dialysis, Continuous Ambulatory ; Renal Dialysis ; Support, Non-U.S. Gov't ; T-Lymphocytes/classification/*immunology ; T-Lymphocytes, Helper-Inducer/immunology ; T-Lymphocytes, Suppressor-Effector/immunology