Vol. 29, pp.585 ~ 589, ml. 1.6 mg/dl 1 MRSA. Table 1 MRI

Transcription

1 Vol. 29, pp.585 ~ 589, ABO ml ABO mg/dl 1 MRSA CYA+ AZ+ MP GSP 4 1 Table Alport 11 CT MRI 143

2 Table 1 Summary of the 8 renal recipients Case Age/Sex Original disease Dialysis Donor/Age Immunosuppression Acute Serum Followup Note rejection creatinine (months) level (mg/dl) 1 15/M Alport syndrome CAPD mother/40y CYA+AZ+MP huge abdoninal cyst 2 14/M CGN CAPD mother/48y CYA+AZ+MP /M renal sclerosis CAPD mother/48y CYA+AZ+MP retroperitoneal abscess 4 48/M IgA nephropathy HD wife/47y CYA+AZ+MP 1 graft loss /M CGN HD wife/43y CYA TAC+AZ+MP posttransplant diabetes 6 36/F IgA nephropathy HD mother/63y TAC+MMF+MP /M hereditary nephritis HD father/47y TAC+MMF+MP+ALG ABO incompatible 8 25/M IgA nephropathy HD sibling/31y TAC CYA+MMF+MP abbreviations: CGN: chronic glomerular nephritis, CAPD: continuous ambulatory peritoneal dialysis, HD: hemodialysis, CYA: cyclosporine A, AZ: azathioprine, MP: methylprednisolone, TAC: tacrolimus, MMF: mycofenorate mofetil, ALG: antilymphocyte globulin mg/dl CAPD a mg/dl CAPD IgA CYA + AZ + MP 4 GSP 4 IIb OKT

3 Ia CYA TAC TAC mg/dl 6 36 IgA 4 63 MMF TAC + MP + MMF mg/dl A O ABO A IgM 126 IgG DFPP 1 8 TAC + MMF + MP mg/dl 8 25 IgA 31 TAC + MMF + MP 3 5 1b OKT3 1.4 mg/dl mg/dl %77%56%

4 ABO % 68% 7 7 A ABO CD3OKT3 IL2R posttransplant lymphocyte proliferative disease; PTLD 8 2 CT MRI 3D-CT MRI 2 mm 9 CT MRI CT 9 6 3D-CD cm 7 8 cm CO Seki T, Tanda K, Chikaraishi T, Takeuchi I, Kanagawa K, Togashi M and Koyanagi T. Addition of deoxyspergualin to standard triple immunosuppressive regimen in kidney transplantation. Transplant 146

5 8 Proc 1996; 28: ,,,,,,, ; 35: ,, ; 54: ,,,,, ; 38: Chikaraishi T, Iwamoto T, Hoshino, T, Makizumi K, Yanagisawa N, Furuhata S, Sasaki H, Kaoto K and Inoue M. Autologous blood transfusion for kidney transplant recipients. Transplant Proc 2000; 32: ,, ; 3: , ABO 2001, 1, ABO,, 2001: Leblond V, Sutton L, Dorent R, Davi F, Bitker MO, Gabarre, J, Charlotte F, Ghoussoub JJ, Fourcade C, and Fischer A. Lymphoproliferative disorders after organ transplantation: a report of 24 cases observed in a single center. J Clin Oncol 1995; 13: ,,,,,,. DSAMRAHelical CT. 2001; 14: Brown SL, Biehl TR, Rawlins MC and Hefty TR. Laparoscopic live donor nephrectomy: a comparison with the conventional open approach. J Urol 2001; 165: Abstract Eight Cases of Kidney Transplantation: Our Initial Experience Tatsusya Chikaraishi, Maki Inoue, Hideo Sasaki, Keiko Kato, Hisashi Tsutsumi, Souichi Furuhata, Takayasu Nishida, Kazuhiko Makizumi, Takao Hoshino, and Teruaki Iwamoto We report our first experience with kidney transplantation. Seven male and 1 female kidney recipients with a mean age of 26.1 years (range 14 49) received allografts from living related or non-related (spouse) donors. ABO blood types were compatible in 7 pairs and incompatible in 1. Although autologous blood transfusion (ABT) is rarely employed in patients with end-stage renal disease, we attempted preoperative ABT for kidney recipients in order to prevent infectious disease or adverse reactions related to allogeneic blood transfusion. The use of ml of predeposited autologous blood was sufficient to prevent need for postoperative allogeneic blood transfusion or blood-product injections in all recipients. A quadruple immunosuppressant regimen comprising cyclosporine, azathioprine, methylprednisolone, and gusperimus (postoperative days 4 to 10) was administered in the initial five recipients. A triple drug immunosuppressive regimen consisting of tacrolimus, micofenorate mofetil, and methylprednisolone was administered in the subsequent three recipients. The one recipient displaying ABO blood type incompatibility recipient was splenectomized with additional anti-lymphocyte globulin to the tacrolimus-based triple drug regimen. Although one graft (ABO blood type compatible case) was lost after severe acute rejection occurring on postoperative day 5, another 4 episodes of acute rejection in 3 recipients were successfully treated using anti-rejection therapies. Serum creatinine levels of the 7 functioning grafts ranged from mg/dl over a minimum observation period of 1 year. All eight recipients are currently alive with (7 cases) or without (1 case) functioning graft. (St. Marianna Med. J., 29: , 2001) Department of Urology St. Marianna University School of Medicine, Sugao, Miyamae-ku, Kawasaki , Japan 147