Group A n 5 : ciclosporin CYA azathioprine AZ methylprednisolone MP

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1 5 Vol. 34, pp. 558, : ABO 4 4 Group A n5: ciclosporin CYAazathioprine AZmethylprednisolone MP gusperimus DSG 4 Group B n7: tacrolimus TACmycophenolate mofetil MMFMP 3 Group C n7: TACMMF MPbasiliximab 4 Group D ABO n4: TACMMFMP 3 DSG Group A 5 3 AR 4 Group B 7 AR 7 Group C 7 2 AR AR 3 Group D 4 3 AR acute rejection: AR 7 7

2 Exel 2002 StatMate III Kaplan Meier Table. Recipient Characteristics Table 2. Donor Characteristics Table Table IgA SLE 3 Table Continuous Ambulatory Peritoneal Dialysis CAPD CAPD 2 6 preemptive Table Table 3 ABO : 5 ciclosporin CYA azathioprine AZ methylprednisolone MPgusperimus DSG 4 Group A 6 7 tacrolimus TAC mycophenolate mofetil MMF MP 3 Group B IL2R basiliximab BAX 4 TACMMFMPBAX 4 Group C ABO : ABO double filtration plasmapheresis: DFPP plasmaexchange: PEX 8 TAC MMFMP 3 DSG Group D 8

3 33 53 Table 3. Method of Immunosuppression and acute Rejection 6ARTable 3 Group A: AR Group B: 7 4.3AR muromonabcd3 OKT3 7 Group C: AR Group D ABO : 4 25 AR DFPP 2 50AR double J stent 2, wall stent 2 6 ARDS II ARB TACMP

4 mgdl.7 mgdl Table Figure. Overall graft survival 0

5 33 55 Table 4. Number of Kidney Transplantation in Asian countries AR Group A CYAAZMPDSG CYA Group B TACMMFMP TAC AZ MMF AR Group B BAX Group C TACMMFMPBAX AR.8 AR Group C BAX MMF 50 AR TAC MMFsteroidBAX

6 56 ARB 7 8 ABO 2000 CT angiography 9 CO 2 0 ABO ABO 2 ABO B rituximab CD20 B ABO ABO 6 rituximab ABO A B ; 40: ; 7:

7 ; 9: ; 40: Gore JL, Pham PT, Danovitch GM, Wilkinson AH, Rosenthal JT, Lipshutz GS and Singer JS. Obesity and outcome following renal transplantation Am J Transplant 2006; 6: Opelz G and Dohler B. Improved long-term outcomes after renal transplantation associated with blood pressure control. Am J Transplant 2005; 5: Premasathian NC, Muehrer R, Brazy PC, Pirsch JD, Becker BN and J Hum. Blood pressure control in kidney transplantation: therapeutic implications. Hypertens 2004; 8: Cosio FG, Pesavento TE, Pelletier RP, Henry M, Ferguson RM, Kim S and Lemeshow S. Patient survival after renal transplantation III: the e#ects of statins. Am J Kidney Dis 2002; 40: Johnson JE, Loveday EJ, Archer LJ, Lear P and Thornton MJ. Preoperative evaluation of live renal donors using multislice CT angiography. Clin Radiol 2005; 60: Fisher PC, Montgomery JS, Johnston WK 3rd and Wolf JS Jr consecutive hand assisted laparoscopic donor nephrectomies: evolution of operative technique and outcomes. J Urol 2006; 75: Hawasli A, Berri R, Meguid A, Le K and Oh H. Total laparoscopic live donor nephrectomy: a 6-year experience. Am J Surg 2006; 9: Tyden G, Kumlien G, Genberg H, Sandberg J, Lundgren T and Fehman I. ABO-incompatible kidney transplantation and rituximab. Transplant Proc 2005; 37: CD20 ABO ; 7 4 MMFrituximab ABO ; ;

8 58 Abstract Kidney Transplantation at St Marianna University Hospital from Tatsuya Chikaraishi, Takeshi Takahashi, Teruaki Iwamoto, Katsunori Yamakawa, Souichi Furuhata, Hisashi Tsutsumi, Satetsu Miyano, Hideo Sasaki, Keiko Kato, Akiko Isogai 2, Yuichi Sato 2, and Kenjiro Kimura 2 Up to May patients with end stage renal disease were transplanted at our center with kidneys from living n30 and cadavaric donors n3. Medical records of the patients and donors were retrospectively reviewed to analyze the outcome of the kidney transplantations. As for recipients, clinical data such as age at transplantation, original disease, duration of dialysis, method of immunosuppression, surgical complications, and graft survival rate were analyzed. Donor age, sex, relationship with the recipient, ABO blood type compatibility, and surgical complications at donor nephrectomy were also investigated. The median age of the recipients was 3years 650. The most common original disease of chronic renal failure was chronic glomerular nephritis 9 cases; 27.3 followed by 8 cases 24.2 of IgA nephropathy. The duration of pre-transplant dialysis raged from 5 to 50 months median 3 months. Thirty grafts were donated from living donors related 27, non-related 3 while three were donated from non-heart beating cadaveric donors. Four pairs were ABO blood type incompatible. Surgical complications in the recipients included stenosis of ureterovesical anastomosis in three, urinary leakage in two, and one kinking of reconstructed renal artery. All of them were corrected surgically. Surgical complication of donor nephrectomy was rare except for one case of surgical site abscess formation which was successfully treated by percutaneous drainage. Four immunosuppression regimens were employed. Group A: Ciclosporin azathioprinemethyl prednisolone MP Group B: Tacrolimus TACMycophenolate Mofetil MMF MP, Group C: TACMMFMPbasiliximab, Group D ABO blood type incompatible: Pre-transplant plasma pheresistacmmfmpdsgsplenectomy. Acute rejection rate was 60 in group A, 4.3 in group B,.8 in group C, and 75 in group D. Four of 33 grafts were lost in this series. One graft in group A was lost on postoperative day 4 due to muromonab CD3 resistant acute rejection. Two grafts were lost in group C. The causes of graft loss were acute rejection combined with acute pneumonia and failure of urinary tract management with subsequent recurrent urinary tract infections. The other graft was lost due to the death of the patient with unknown cause of cardiac and pulmonary arrest. Overall year and 5 year graft survival rate was 89.6 and 85.2, respectively. No life threatening infections were observed in the recipients. Department of Urology, St. Marianna University School of Medicine 2 Integrated care center of renal diseases, St. Marianna University Hospital 4

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