A clinical observation was made on 33 cases of donor for renal transplantation in the Department of Urology, College of Medicine, Hanyang University from June 1978 to March 1981. The results are as follows; 1) In 32 cases of the 12 cases were male and 20 cases female, 5th decade was most common among them. 2) Relationship between donor was 20 cases, unrelated donor 2 cases and 2 cases cadaver donor. 3) The side of donor kidney was almost left side kidney.; Lt. side: 21 cases, Rt side: 6 cases. 4) There were no specific complications except 5 cases of wound infection.
Cadaver ; Female ; Humans ; Kidney ; Kidney Transplantation* ; Male ; Nephrectomy* ; Tissue Donors* ; Unrelated Donors ; Urology ; Wound Infection

Acute rejection after renal transplantation is still the most common cause of graft failure during the early post-transplant period. To determine whether an acute rejection episode adversely affects long-term graft survival, we retrospectively analyzed our single center patients population of 1266 consecutive living donor kidney transplantations performed between April 1984 and October 1995. Five hundred twenty three recipients(41.3%) experienced 711 acute rejection episodes. Among these 711 episodes, 92.6% were respond to anti-rejection therapy and treatment failure rate was 7.6%. Late onset acute rejection, which developed 1 year after transplantation, showed poor treatment response(79.7%). There was statistically significant difference of graft survival rate between acute rejection free group and acute rejection group. Furthermore, the frequency of acute rejection, response rate the steroid pulse therapy and the degree of remission affected the graft survival rate. Donor source impacted on the development of acute rejection-33.1% in living related donor, 39.9% in living unrelated donor and 57.1% in cadaveric donor transplantation. In living related donor kidney transplantations, HLA identical pairs(11%) showed less acute rejection episodes than HLA haplo-identical pairs(38.7%). In living unrelated donor kidney transplantations, HLA antigen match adversely affected the acute rejection rate-43.9%, 35.8% and 30.6% in 1~2, 3 and 4~5 Ag match group, respectively. ABO blood group compatibility, recipient's age and compatibility of HLA DR Ag did not influenced to the development of acute rejection. These results suggest that the acute rejection could be a major determinant of long-term graft outcome.
Allografts* ; Cadaver ; Graft Survival ; Humans ; Immunosuppression ; Kidney Transplantation ; Living Donors ; Retrospective Studies ; Tissue Donors ; Transplants* ; Treatment Failure ; Unrelated Donors

Acute rejection after renal transplantation is still the most common cause of graft failure during the early post-transplant period. To determine whether an acute rejection episode adversely affects long-term graft survival, we retrospectively analyzed our single center patients population of 1266 consecutive living donor kidney transplantations performed between April 1984 and October 1995. Five hundred twenty three recipients(41.3%) experienced 711 acute rejection episodes. Among these 711 episodes, 92.6% were respond to anti-rejection therapy and treatment failure rate was 7.6%. Late onset acute rejection, which developed 1 year after transplantation, showed poor treatment response(79.7%). There was statistically significant difference of graft survival rate between acute rejection free group and acute rejection group. Furthermore, the frequency of acute rejection, response rate the steroid pulse therapy and the degree of remission affected the graft survival rate. Donor source impacted on the development of acute rejection-33.1% in living related donor, 39.9% in living unrelated donor and 57.1% in cadaveric donor transplantation. In living related donor kidney transplantations, HLA identical pairs(11%) showed less acute rejection episodes than HLA haplo-identical pairs(38.7%). In living unrelated donor kidney transplantations, HLA antigen match adversely affected the acute rejection rate-43.9%, 35.8% and 30.6% in 1~2, 3 and 4~5 Ag match group, respectively. ABO blood group compatibility, recipient's age and compatibility of HLA DR Ag did not influenced to the development of acute rejection. These results suggest that the acute rejection could be a major determinant of long-term graft outcome.
Allografts* ; Cadaver ; Graft Survival ; Humans ; Immunosuppression ; Kidney Transplantation ; Living Donors ; Retrospective Studies ; Tissue Donors ; Transplants* ; Treatment Failure ; Unrelated Donors

We have performed 190 renal transplantations from August 1990 to June 1996. No cadaveric donor was used and all except one were first grafts. We conducted a clinical analysis, especially concerning the factors affecting acute rejection and graft function at 1 year. The results were as follows : 1) The mean ages of donor and recipient were 35.3 years and 37.4 years respectively. The ratio of male to female was 1.4 : 1 and 1.5 : 1, respectively. 2) One hundred and six cases(55.8%) were living unrelated donors and eighty four cases(44.2%) were living related donors. 3) One hundred and sixty six potential recipients were given 3 donor specific transfusions(DST), started about 5 weeks prior to transplantation with cyclosporin coverage. Six of these patients(3.6%) developed sensitization by DST that precluded the subsequent transplantation and the remaining 160 patients received the kidney from the blood donors. Another 28 recipients were given DST 24 hours prior to operation. 4) Most of initial acute rejection episodes(71 episodes, 95%) appeared within the first month of post-transplantation. 5) We analyzed the possible factors affecting the incidence of acute rejection. Donor age and HLA incompatibility were significant statistically(p<0.05). 6) Multiple regression analysis showed that a number of acute rejection episodes(p<0.001) was the only independent risk factor for the graft function at 1 year. 7) Overall graft and patient survival rate were 97.2% and 98.6% at 1 year, 94.1% and 95.5% at 3 years.
Blood Donors ; Cadaver ; Cyclosporine ; Female ; Humans ; Incidence ; Kidney ; Kidney Transplantation* ; Male ; Risk Factors ; Survival Rate ; Tissue Donors ; Transplants ; Unrelated Donors

The incidence of malignant disease increases in kidney transplant recipients taking immunosuppressive therapy. Extramammary Paget's disease, a very rare dermatologic malignancy, is characterized by frequent recurrences and coexistence with other malignancies. Although skin cancer is the most common malignancy occurring after kidney transplantation, extramammary Paget's disease has not been reported in Korea. In this paper, we report a case of recurrent extramammary Paget's disease after renal transplantation. A 66-year old man, who underwent renal transplantation from a living unrelated donor 15 years ago, was diagnosed to have extramammary Paget's disease 7 years ago. At this admission he was troubled with a pruritic skin lesion in his suprapubic area which previously occurred twice. The recurring Paget's disease was treated with radical resection and coverage. No further recurrences have been developed during the following 12 months until now.
Humans ; Incidence ; Kidney ; Kidney Transplantation ; Korea ; Paget Disease, Extramammary ; Recurrence ; Skin ; Skin Neoplasms ; Unrelated Donors

Allogeneic hematopoietic stem cell transplantation (allo-HSCT) has three decades history in China. During these periods, the number of HSCT has been increasing, donor and stem cell sources were expanded, indication of diseases and patients for HSCT extended. Forty-two HSCT units offered their data 1–6 times from July 2007 to June 2010. The annual increase rates were 8.8% to 10.8%. Matched sibling donor is 41%, mismatched related/haploidentical donor is 24%, unrelated volunteer donor is 16%, and umbilical cord blood is 2%. The indications of major disease entities are acute myeloid leukemia (AML, 35%), acute lymphobastic leukemia (ALL, 25%), chronic myeloid leukemia (CML, 21%), and myelodysplastic syndrome (MDS, 8%). The different opinions on the indication of HSCT were supported by some trials, matched/haploidentical HSCT fit for middle or high risk ALL and AML in first complete remission (CR1), the international prognosis score system (IPSS) — middle-II/high risk MDS, CML in advanced stage and so on, when patients have no matched sibling donor. In the Peking University Institute of Hematology, Peking University People's Hospital, haploidentical HSCT has received a comparable result to matched simbling donor HSCT and unrelated matched donor HSCT; we suggest haploidentical donor might be a routine alternative donor for high-risk patents who need an urgent HSCT without matched related donor in special center.
China ; Geography ; Hematopoietic Stem Cell Transplantation ; statistics & numerical data ; Humans ; Unrelated Donors

OBJECTIVETo evaluate the efficacy of HLA- haploidentical donor hematopoietic transplantation (Haplo- HSCT)for severe aplastic anemia (SAA)by compared with the same period of unrelated donor transplantation (UD- HSCT).

METHODSOf a cohort of 50 SAA patients between September 2012 and July 2014, 26 patients underwent UD- HSCT and 24 patients Haplo- HSCT.

RESULTSOS rate was 91.3% with a median follow-up of 9 (2-26)months. According to transplant type, there was no significant difference between UD- and Haplo-HSCT (96.1%vs 86.0%,P=0.30). 3 of 50 (6%)patients had primary engraft failure. Haplo- HSCT developed higher significantly incidence of Ⅱ- Ⅳ aGVHD (37.5%vs 3.83%,P=0.003)and cGVHD (37.5%vs 15.3%,P=0.030)than UD-HSCT. Haplo-HSCT also had significantly higher incidences of CMV viremia (78.2%vs 46.1%,P=0.005)and EBV viremia (43.1%vs 16.0%,P=0.040), respectively than UD-HSCT. But the incidences of hemorrhagic cystitis were similar between two transplant types (39.1%vs 23.0%,P=0.120).

CONCLUSIONThis study showed favorable outcome of Haplo-HSCT for SAA, which was comparable with UD-HSCT.

BACKGROUND: Lung transplantation (LTx) is an effective treatment for end stage lung disease. However, the shortage of donor lungs has been a major limiting factor to increase the number of LTx. Ex vivo lung perfusion (EVLP) is a currently approved method to evaluate lung function and to repair donor lung with poor function. The purpose of this study was to develop EVLP system in pig model and to maintain lung function during 4 hours of EVLP. METHODS: Bilateral lung blocks were harvested from five 40 kg pigs. These blocks were applied in EVLP perfused with 37degrees C Steen solution. We performed arterial blood gas (ABG) analyses before death and also every 1 hour for 4 hours after application of EVLP and calculated oxygen capacities (OC) using the results of ABG. We also calculated pulmonary vascular resistance (PVR) and peak airway pressure (PAP) every 1 hour for 4 hours. After EVLP procedure, we excised specimens for pathologic review. RESULTS: We found that OC gradually decreased during the 4 hour period of EVLP; however, no statistically significant difference was obtained. PVR declined sharply after 1 hour of EVLP (P=0.031) and then remained constant for 3 hours. PAP significantly increased after 3 hours (P<0.0001). Pathologic investigations revealed various findings from normal lung to severe pulmonary edema. CONCLUSIONS: On the results of this study, we could preserve the lung function for 4 hours using EVLP. We conclude that application of EVLP in clinical setting can make more donor lungs available for LTx. However, we also understand that more studies and training are needed in clinical practice.
Humans ; Lung ; Lung Diseases ; Lung Transplantation ; Organ Preservation ; Oxygen ; Perfusion ; Swine ; Tissue Donors ; Unrelated Donors ; Vascular Resistance

PURPOSE: Umbilical cord blood as the source of hematopoietic stem cells has several advantages over bone marrow cells for transplant purpose, but the limitation inherent in the cord blood is its limited number of hematopoietic stem cells. The responses of cord blood mononuclear cells (MNC) which were stimulated by unrelated cord blood MNC or adult peripheral blood MNC to investigate the possibility of unrelated, HLA-mismatched multiple cord blood transplantation were evaluated. METHODS: Nineteen cord blood and 7 adult peripheral blood samples were used. Each of the MNC from cord blood and adult peripheral blood was cultured before and after 2,000 cGy irradiation. Mixed MNC cultures with cord blood and irradiated different cord blood or irradiated adult peripheral blood were performed. RESULTS: The mean percentages of MNC counts compared to day 0 of day 2 and day 7 cultures of mixed MNC cultures with cord blood and irradiated different cord blood were 92.5 55.8%, 57.4 51.0% and those of mixed MNC cultures with cord blood and irradiated adult peripheral blood were 143.4 132.7%, 113.4 95.1%, respectively. The difference of the cell count changes in 2 types of MNC cultures was statistically significant (P<0.05). CONCLUSION: The proliferative responses of cord blood MNC to different cord blood MNC were significantly lower than those to adult peripheral blood MNC. The study for the investigation of clinical applicability of cord blood transplantation from multiple unrelated donors to overcome the limitation of the cell dose of cord blood transplantation and the shortage of related or unrelated HLA-matched donors is needed.
Adult* ; Bone Marrow Cells ; Cell Count ; Cell Culture Techniques* ; Fetal Blood* ; Hematopoietic Stem Cells ; Humans ; Tissue Donors ; Unrelated Donors

Allogeneic hematopoietic stem cell transplantation (HSCT) is a curative treatment for children and adolescents with various malignant and non-malignant diseases. While human leukocyte antigen (HLA)-identical sibling donor is the preferred choice, matched unrelated volunteer donor is another realistic option for successful HSCT. Unfortunately, it is not always possible to find a HLA-matched donor for patients requiring HSCT, leading to a considerable number of deaths of patients without undergoing transplantation. Alternatively, allogeneic HSCT from haploidentical family members could provide donors for virtually all patients who need HSCT. Although the early attempts at allogeneic HSCT from haploidentical family donor (HFD) were disappointing, recent advances in the effective ex vivo depletion of T cells or unmanipulated in vivo regulation of T cells, better supportive care, and optimal conditioning regimens have significantly improved the outcomes of haploidentical HSCT. The ex vivo techniques used to remove T cells have evolved from the selection of CD34+ hematopoietic stem cell progenitors to the depletion of CD3+ cells, and more recently to the depletion of αβ+ T cells. The recent emerging evidence for ex vivo T cell-depleted haploidentical HSCT has provided additional therapeutic options for pediatric patients with diseases curable by HSCT but has not found a suitable related or unrelated donor. This review discusses recent advances in haploidentical HSCT, focusing on transplant using ex vivo T cell-depleted grafts. In addition, our experiences with this novel approach for the treatment of pediatric patients with malignant and non-malignant diseases are described.
Adolescent* ; Child* ; Hematopoietic Stem Cell Transplantation* ; Hematopoietic Stem Cells* ; Humans ; Leukocytes ; Siblings ; T-Lymphocytes ; Tissue Donors ; Transplants* ; Unrelated Donors ; Volunteers