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.
Allografts* ; Cyclosporine* ; Humans

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

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

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

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

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

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

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

Generally, the left kidney from a living donor is more commonly preferred but the right kidney is occasionally donated because of multiple left renal arteries or repeated transplantation. The right donor nephrectomy is usually more difficult compared to the left because the right renal vein is often multiple and short, which complicates dissection of the vascular pedicle. From Jan. 1989 to Sep. 1992, 112 consecutive cases of right donor nephrectomies out of a total of 771 cases were retrospectively reviewed with the preoperative renal angiography and the intraoperative assessment of the right renal vascular pedicle. The indications for right donor nephrectomy include 1) multiple or proximal bifurcating renal arteries of the left kidney (89.3%), 2) repeated transplantation in the recipient (9%). In 26.8% of the cases, there were more than two right renal veins. In the right donor nephrectomy, it is often necessary to perform vena cava cuff resection because of short and frequently occurring multiple right renal veins. For the dissection of the inferior vena cava (IVC), the aberrantly occurring right gonadal vein, the adrenal vein draining above the junction of the renal vein and IVC, and the lumbar vein below the junction should always be looked for and must be ligated if any are found.
Adult ; Blood Vessels/anatomy & histology ; Female ; Human ; Intraoperative Period ; Kidney/*blood supply ; Male ; Nephrectomy/*methods ; Retrospective Studies ; *Tissue Donors