ABSTRACT
OBJECTIVE: Graft survival rate has been improved due to newly developed immunosuppressive agents, care of recipient and operative method. However, since many risk factors are still threatening the graft survival, many studies have been underway to identify such factors, one of which has been on delayed graft function(DGF). Extending the definition of DGF to oliguria within 2 months postoperative period(POP), we began this study in order to evaluate what effects oliguria within 2 months POP have on graft survival and what are the risk factors involved. METHODS: 103 patients who have had renal transplantation performed were divided into two groups (oliguric group and non-oliguric group), based on the presence or absence of oliguria within 2 months POP. Risk factors such as the recipient factors(age, gender), donor factors(age, gender), operative factors(warm ischemia time, intraoperative urine volume), HLA typing, postoperative hypotension, postoperative hypovolemia were compared between the two groups and the impact of oliguria on graft outcome was also analysed. RESULTS: 1) 14 were Oliguric patients and 89 were nonoliguric patients. 2) One-year graft survival rate was 40% in the oliguric group and 98% in the non-oliguric group(P<0.05). 3) As the result of analyzing the risk factors, non living related donor(living non-related donor and cadaver donor) were 7(50%) in the oliguric group and 16(18%) in the non-oliguric group(P<0.05). The mean intraoperative urine volume was 442m1 in the oliguric group and 774m1 in the non-oliguric group(P<0.05). The occurrence of postoperative hypotension were 5(36%) in the oliguric group and 1(1%) in the non-oliguric group(P<0.05). Other risk factors such as the recipient fractors, donor factors, warm ischemia time, HLA typing and postoperative hypovolemia were not significantly different between the two groups. CONCLUSION: Graft survival rate in the oliguric group was lower than in the non-oliguric group. The risk factors for oliguria were non living related donor, intraoperative urine volume lower than 500m1 and postoperative hypotension. In conclusion, renal transplantation from non living related donor needs to be proceeded with caution; the maintenance of intraoperative urine volume and the prevention of postoperative hypotension are essential for better graft outcome.
Subject(s)
Humans , Cadaver , Graft Survival , Histocompatibility Testing , Hypotension , Hypovolemia , Immunosuppressive Agents , Ischemia , Kidney Transplantation , Oliguria , Postoperative Period , Risk Factors , Tissue Donors , Transplants , Warm IschemiaABSTRACT
BACKGROUND: Prostaglandin system is known to participate in manifestation of the renin-angiotensin system. However, role of prostaglandins on the renin-angiotensin system in development of hypertension is not well established. This study was to examine whether the role of prostaglandins is altered in experimental hypertension. METHODS: Two-kidney, one-clip(2KIC) renal hypertension was made by clipping the left renal artery with a silver clip(internal gap of 0.2mm) and deoxycorticosterone acetate (DOCA)-salt hypertension by subcutaneous implantation of DOCA(200mg/kg) strip plus saline(1%) drinking. They were used 3 weeks later. Age-matched normal rats served as a control. Femoral artery was cannulated and arterial blood pressure and heart rate were monitored continuously. RESULTS: 1) In normotensive rats, saralasin infusion(20 microg/kg/min, IV) caused a decrease in mean arterial pressure without significant alterations in heart rate. Indomethacin-pretreatment(10mg/kg, IP) abolished the depressor response to saralasin. 2) The depressor response to saralasin was more marked in renal hypertensive rats than in normotensive rats. The magnitude of maximum decrease in blood pressure, however, was comparable between the hypertensive and normotensive rats. Indomethacin-pretreatment did not affect the depressor response to saralasin in renal hypertensive rats. 3) In DOCA-salt hypertensive rats, saralasin infusion rather caused an increase in mean arterial pressure without significant alterations in heart rate. The pressor response to saralasin was not affected by indomethacin-pretreatment. CONCLUSION: These results indicate that prostaglandin system may modify renin-angiotensin system in normotensive rats. It is suggested that mechanisms other than prostaglandin system participate in the full-blown manifestation of renin-angiotensin system in 2KIC renal hypertensive rats.
Subject(s)
Animals , Rats , Arterial Pressure , Blood Pressure , Desoxycorticosterone , Drinking , Femoral Artery , Heart Rate , Hypertension , Hypertension, Renal , Prostaglandins I , Prostaglandins , Renal Artery , Renin-Angiotensin System , Saralasin , SilverABSTRACT
No abstract available.