Simultaneous chylothorax and chylous ascites / 영남의대학술지

Chylothorax or chylous ascites are rare manifestations of liver cirrhosis. We report a rare case of simultaneous chylothorax and chylous ascites in a patient with hepatitis B virus-related liver cirrhosis. A 76-year-old woman was referred to our hospital with a pleural effusion on her right side. She had no history of recent medical procedures, trauma or tumor. There was no evidence of mass or thoracic duct obstruction in a computed tomography scan. Pleural fluid and ascites were confirmed as chylothorax and chylous ascites by chemistry analysis. Despite thorough conservative care, there was no improvement. Pleurodesis was planned, but hepatic encephalopathy developed suddenly and she did not recover.

Double primary lung adenocarcinoma diagnosed by epidermal growth factor receptor mutation status / 영남의대학술지

A nodular density was detected on a chest radiograph taken from a 57-year-old Korean woman who was visiting a hospital for a routine check. Chest computed tomography revealed a 4.8 cm lobulated mass in the right lung and another focal nodular lesion in the left lung; biopsies of both lungs revealed adenocarcinoma. We conducted DNA sequencing and peptide nucleic acid clamping to investigate the potential double primary lung cancer. The results verified that the mass in the right lung had a mutation in the epidermal growth factor receptor, whereas the nodule in the left lung had a wild-type sequence, showing that these two were genetically different cancers from one another. Thus, we demonstrate that genetic testing is useful in determining double primary lung cancer, and we herein report on this case.

Simultaneous chylothorax and chylous ascites / 영남의대학술지

Chylothorax or chylous ascites are rare manifestations of liver cirrhosis. We report a rare case of simultaneous chylothorax and chylous ascites in a patient with hepatitis B virus-related liver cirrhosis. A 76-year-old woman was referred to our hospital with a pleural effusion on her right side. She had no history of recent medical procedures, trauma or tumor. There was no evidence of mass or thoracic duct obstruction in a computed tomography scan. Pleural fluid and ascites were confirmed as chylothorax and chylous ascites by chemistry analysis. Despite thorough conservative care, there was no improvement. Pleurodesis was planned, but hepatic encephalopathy developed suddenly and she did not recover.

Double primary lung adenocarcinoma diagnosed by epidermal growth factor receptor mutation status / 영남의대학술지

A nodular density was detected on a chest radiograph taken from a 57-year-old Korean woman who was visiting a hospital for a routine check. Chest computed tomography revealed a 4.8 cm lobulated mass in the right lung and another focal nodular lesion in the left lung; biopsies of both lungs revealed adenocarcinoma. We conducted DNA sequencing and peptide nucleic acid clamping to investigate the potential double primary lung cancer. The results verified that the mass in the right lung had a mutation in the epidermal growth factor receptor, whereas the nodule in the left lung had a wild-type sequence, showing that these two were genetically different cancers from one another. Thus, we demonstrate that genetic testing is useful in determining double primary lung cancer, and we herein report on this case.

Current Status and Corresponding Strategy of Transplant Tourism / 대한이식학회지

Transplant tourism (TT) has developed into a global concern for international organizations, transplant communities, researchers, and the press. Increasing the knowledge of organ trafficking and TT is essential to raise awareness and prepare responses that will prevent the occurrence of illicit organ transplantation through TT. This review article describes the current status and legal framework of international organ trafficking and TT. Collection and analysis of data concerning TT from national and international registries will provide the best estimates of global activities, which are necessary to develop an appropriate local and worldwide collaborative response to organ trafficking and TT. International collaboration and multifaceted strategies are needed to address the complex challenges of TT.

Does Pregnancy after Renal Transplantation Affect Their Allograft and Pregnancy Outcomes? / 대한이식학회지

BACKGROUND: The number of pregnancies in renal transplant recipients has increased. Many studies have shown that pregnancy increases the risk of graft, fetal, and maternal complications but does not affect the long-term outcome of the graft. We assessed the incidence and effect of pregnancy after renal transplantation and examined graft, fetal, and maternal outcomes. METHODS: Our study included 145 female recipients of child-bearing age (15~45 years) in our center from January 1990 to December 2011. The subjects were divided into two groups: pregnancy (n=17) and control (n=128). The 26 pregnancies in the 17 recipients were categorized as live births (n=10) or no-live births (n=16). These were analyzed for evaluation of pregnancy outcomes, graft function, and long-term graft survival. RESULTS: The pregnancy and control group had similar graft function and graft survival rates 5- and 10-year after renal transplantation. Outcomes of pregnancy were 10 live births, 8 therapeutic abortions, 7 spontaneous abortions, and 1 stillbirth. The mean serum creatinine levels of the pregnant recipients diminished during the first trimester (1.14+/-0.37 mg/dL) and increased slightly during the third trimester (1.18+/-0.37 mg/dL) to levels nearer the baseline (1.23+/-0.37 mg/dL). These ranges were stable. The mean time from transplantation to pregnancy was 20.73+/-3.57 months. Live birth rates were associated with the time from transplantation to pregnancy (71.78+/-37.75 months for live births and 19.38+/-12.71 months for no-live births, P=0.000). There were no significant differences in graft function, graft failure rates, and survival. CONCLUSIONS: Pregnancy does not appear to have an adverse effect on graft function and the long-term outcomes of renal transplantation. Recipients with stable renal function who want to become pregnant can have successful pregnancies.

A 45-Year-Old Man With Recurrent Dyspnea and Hemoptysis during Exercise: Exercise-Induced Pulmonary Hemorrhage/Edema / 결핵및호흡기질환

A 45-year-old man presented with dyspnea and hemoptysis during exercise. A chest computed tomography (CT) revealed multifocal diffuse patchy ground glass opacity and interlobular septal thickening in both the lungs. Permeability pulmonary edema or pulmonary hemorrhage was suspected. Serologic studies for autoimmune disorders and vasculitis were negative. There was no laboratory evidence of coagulopathy, other hematopoietic disease or infectious disease. Considering correlation with exercise, we diagnosed exercise-induced pulmonary hemorrhage (EIPH) or exercise-induced pulmonary edema (EIPE). The patient was managed with antifibrinolytics, antibiotics, and antitussive agent. After a week, follow-up chest CT revealed completely resolved pulmonary hemorrhage. About 2 months after the first event, he visited again with dyspnea and hemoptysis during running. In the present study, we report a case of recurrent pulmonary hemorrhage after exercise.

Incidence of Post-transplant Malignancy after Renal Transplantation: Single Center Analysis / 대한이식학회지

BACKGROUND: Immunosuppression after kidney transplantation is associated with increased risk of malignancy, which has become the second most common cause of death among kidney transplant recipients. In this review, we report the incidence of malignancies after kidney transplantation in a single center and evaluate the incidence, characteristics, relationship to immunosuppressive drugs and discuss what clinicians must consider during a follow-up of patients after kidney transplantation. METHODS: Between May 1978 and September 2013, a total of 748 kidney transplant patients who were able to undergo a follow-up process through electronic medical records were enrolled in this retrospective cohort study to determine the potential incidence and types of malignancy that may occur after kidney transplantation and the associated impact on patients and graft survival. RESULTS: Among 748 patients, 63 cases of malignancy appeared in 54 patients (7.2%). Gastrointestinal cancer (12 cases, 19%) and post-transplant lymphoproliferative disorder (12 cases, 19%) were the two most common types of malignancy. The second most common type of malignancy was urinary tract malignancy in 10 patients. Two different types of malignancy were diagnosed in nine patients during our follow-up. The overall graft survival in malignancy patients was better, which may mean that malignancy did not affect the overall graft loss. CONCLUSIONS: Clinicians should be aware of the incidence of malignancy in transplant patients and perform routine examinations for early detection of malignancy.

Health Status and Health-promoting Lifestyle for Living Donors after Kidney Donation Through Survey / 대한이식학회지

BACKGROUND: Normal renal function and health have been recognized as important factors in living donors after kidney donation. The purpose of this study was to evaluate the health status and health-promoting lifestyle in living donors after kidney donation. METHODS: A total of 678 living-kidney donors were counted in our center from January 1990 to December 2011. Only 84 donors agreed to participate in the survey by telephone. We received consent for participation in our survey from 48 donors (57.1%). Data were collected from May to August 2013 using donor characteristics, health status, and Health Promoting Lifestyle Profile I (HPLP-I). RESULTS: The donors were predominantly female (62.5%) and the average age was 48.9+/-11.8 years, and the average period after nephrectomy was 9.7+/-5.7 years. The characteristics of donors included ideal body weight (37.5%), overweight (37.5%) in body mass index, and good health status (81.3%). Most donors underwent an annual medical check-up (56.2%), no health problem (81.3%), and no disease (64.6%). However, one patient was treated with dialysis for renal failure due to diabetes. The total average score for HPLP-I was 128.3+/-13.9. Higher than average scores (116.3+/-19.1) were observed for the general middle-aged woman. There were statistically significant differences in self-realization and nutrition in subsection of HPLP-I. Self-realization showed a higher score for Christian (F=2.743, P=0.041) and good health (F=3.389, P=0.017). Nutrition showed a higher score for overweight, obesity (F=6.783, P=0.000), and older than 60 (F=3.854, P=0.009). CONCLUSIONS: Most living kidney donors were healthy after their donation and had relatively high scores for health-promoting lifestyle. However, one patient had a serious health problem. In addition, younger, longer period after donation, and the rare health examination of donors showed a lower health-promoting lifestyle. Designed and continuous health-care management after transplantation is needed for kidney donors.

Spontaneous Superior Mesenteric Artery Branch Pseudoaneurysm / 대한혈관외과학회지

Spontaneous pseudoaneurysm of the superior mesenteric artery (SMA) is rare. However, it may have severe life-threatening complications such as ruptures or thrombosis. Our patient has developed a pseudoaneurysm, which was being misdiagnosed as superior mesenteric vein dissection by the computed tomography angiography. The pseudoaneurysm is revealed from branches of the SMA with no specific causes and is being treated by endovascular embolization after emergency exploratory laparotomy.

Disseminated Cryptococcosis with Cutaneous Manifestation in a Renal Transplant Recipient: A Case Report / 대한이식학회지

Cryptococcosis commonly affects patients with immune dysfunction, as in the case of immunosuppression in organ transplant patients or as acquired immunodeficiency syndrome in patients afflicted with human immunodeficiency virus. The varied appearance of cryptococcal skin lesion makes clinical diagnosis of cutaneous cryptococcosis difficult. Cryptococcosis proves to be a fatal fungal infection in the immunocompromised patient. Therefore, diagnosis and early treatment of cryptococcosis become vital. A 56-year-old renal transplant recipient, with an ongoing immunosuppression regimen of cyclosporine, prednisolone, and mycophenolate mofetil, was admitted with a 2-week history of pain and edema of right arm without respiratory symptoms. Despite empiric antibiotic therapy, the patient continued to complain of severe tenderness of the involved arm and fever persisted as well. On the third day of hospital stay, a biopsy of the erythematous skin lesion was acquired. On the eighth day of hospital stay, results of both skin biopsy and blood cultures showed the presence of Cryptococcus neoformans. The treatment was begun with intravenous fluconazole (400 mg/day). After 4 days of antifungal treatment, the patient developed fever along with cough with purulent sputum. As the new developing symptoms were suggestive of pneumonia, especially of pulmonary cryptococcosis, the antifungal agent was changed from fluconazole to amphotericin B treatment (0.8 mg/kg, 50 mg/day). Chest computer tomography showed improvement in the pneumonic infiltration and consolidation after 4 weeks of amphotericin B treatment. In conclusion, cellulitis in immunocompromised patients should be suspected in case of highly atypical infectious etiology, and skin biopsy should not be delayed if empiric antibiotic therapy does not control the inflammatory response. Additionally, the patient should be treated with intravenous amphotericin B treatment in case of severe cryptococcosis.

Comparison of serum cystatin C and creatinine as a marker for early detection of decreasing glomerular filtration rate in renal transplants / 대한외과학회지

PURPOSE: We wished to compare the clinical effectiveness of cystatin C (CyC) and serum creatinine (sCr) to assess renal function in renal transplantation patients. METHODS: We compared the clinical effectiveness of CyC with that of the sCr to estimate 24-hour urine creatinine clearance (CrCl) in 72 adult recipients who underwent renal transplantation from January 2001 to December 2008. We analyzed the data in terms of accuracy, bias, precision and sensitivity as a function of length of time posttransplantation and CrCl value. RESULTS: The patients were divided into four groups according to CrCl value or =90 mL/min/1.73 m2. The corresponding Cr-based glomerular filtration rate (GFR) estimates had accuracies of 0.71, 0.906, 0.963, and 1.00 within 50% of the reference, with biases (mean percentage errors) of 4.7, 5.32, -5.79, -31.33 mL/min/1.73 m2, and precisions (mean absolute percentage errors) of 7.57, 10.03, 14.52, and 31.33 mL/min/1.73 m2, respectively. The CyC-based GFR estimates had accuracies of 0.35, 0.79, 0.93, and 0.67 within 50% of the reference, respectively, with biases of 15.03, 13.37, -5.58, and -34.79 mL/min/1.73 m2 and precisions of 15.03, 14.80, 17.91, and 34.79 mL/min/1.73 m2. The sensitivity for detecting GFR below 60 mL/min/1.73 m2 was higher for CyC (0.96, 1, and 0.95) than for Cr (0.77, 0.75, and 0.82). CONCLUSION: CyC is a more sensitive indicator of low GFR (CrCl <60 mL/min/1.73 m2) than sCr. However, CyC-based GFR estimates are restrictive data, and are neither accurate nor specific. Therefore, to evaluate renal function, we may need a revised CyC-based GFR formula and close monitoring of sCr.

The Quality of Life for Living Donors after Kidney Transplantation / 대한이식학회지

BACKGROUND: The impact on quality of life (QOL) and safety has increasingly been an important consideration for living donors after kidney transplantation. The purposes of this study were to evaluate the QOL of living kidney donors and to indentify factors for impediment of their QOL. METHODS: The subjects of this study were 69 living kidney donors with whom transplantations were performed in our center from 1990 to 2010. The data was collected from May to July 2010 using donor characteristics and SF-36. RESULTS: The donors were predominantly female (60.9%) and the average age was 45.4+/-12.0 years. The total numbers of donors, categorized by their relationship to the recipients, included 20 siblings (29.0%), 17 parents (24.6%) and 13 spouses (18.8%). The measured characteristics as related to donation included the full return to normal pre-donation activities (72.5%), no visit to a hospital or pharmacy after donation (69.6%) and donation decision as propria persona (97.1%). Most donors were satisfied with their donation (92.8%) and had no regrets for making the donation (87.0%). The average score for QOL of all subjects was 71.89. The overall QOL of living kidney donors revealed lower scores (48.56+/-5.45) as compared to average scores (50) of the healthy population in the USA. In particular, the scores for PCS (52.87) on the SF-36 were higher than the scores for MCS (44.25). CONCLUSIONS: Most living kidney donors were satisfied with their donation and showed good physical recoveries despite a lower QOL. Consequently, carefully pre-transplantation psychological assessment and programs are necessary to support donors. Systematic and continuous management after transplantation, as well as preoperatively appropriate information and counsel, is needed for kidney donors.

The Effects of the Preoperative Serum Homocysteine Level on Restenosis after Infraninguinal Bypass Surgery or Endovascular Surgery for Peripheral Arterial Disease

PURPOSE: Hyperhomocysteinemia is accepted as an independent risk factor for peripheral arterial disease (PAD). The purpose of this study is to evaluate the correlation between the preoperative plasma homocysteine concentration and restenosis after therapeutic revascularization. METHODS: We retrospectively analyzed the clinical records of 58 consecutive patients (they were confined to Trans Atlantic Inter-Society Consensus [TASC] type C & D) among 103 patients who were diagnosed as having infrainguinal PAD and who were treated with bypass surgery or endovascular surgery from July 2003 to July 2009. We analyzed the effect of several factors such as gender, age, the plasma lipid profile and the protein C, protein S, fibrinogen, C-reactive protein, diabetes mellitus, hypertension, ankle-brachial index (ABI), and homocysteine levels, which are all considered to be risk factors for restenosis. Multivariate and univariate analyses were performed to assess the effect of possible confounders. RESULTS: The subjects were 50 men and 8 women (mean age: 63.8+/-10.9). There were 33 (56.9%) cases of bypass surgery and 25 (43.1%) cases of endovascular surgery. Of them, 19 cases (32.8%) showed restenosis after revascularization. In the patients with restenosis, 18 cases (94.7%) showed a preoperative high plasma homocysteine level and 1 case (5.2%) showed a normal level. A lower ABI and hyperhomocysteinemia were significantly more common in the patients with restenosis (P=0.025, P<0.001). There were no significant differences of the other factors, except for the plasma homocysteine level on multivariate analysis (P=0.001). CONCLUSION: We can regard the preoperative hyperhomocysteinemia level as a predictive marker of restenosis after revascularization. Special attention may need to be given to the patients who have a lower preoperative ABI and hyperhomocysteinemia after revascularization.

The Efficacy and Outcome of Reduced Dose of Tacrolimus in Renal Transplantation / 대한이식학회지

BACKGROUND: Immunosuppressive regimens with the fewest possible toxic effects are desirable for transplant recipients. This study evaluated the efficacy and relative toxic effects of four immunosuppressive regimens. METHODS: We assigned 299 renal-transplant recipients to receive group A (standard-dose cyclosporine, mycophenolate mofetil, and corticosteroids), group B (low-dose cyclosporine, basiliximab induction, mycophenolate mofetil, and corticosteroids), group C (standard-dose tacrolimus, mycophenolate mofetil, and corticosteroids), or group D (low-dose tacrolimus, basiliximab induction, mycophenolate mofetil, and corticosteroids) regimens. We compared the groups according to graft function through estimated glomerular filtration rate (GFR), acute rejection, and allograft survival. RESULTS: The mean calculated GFR in patients receiving low-dose tacrolimus (76.4 mL per minute) was higher than in the other three groups (range, 66.3 to 73.8 mL per minute). The rate of biopsy-proven acute rejection was lower in patients receiving low-dose tacrolimus (14.3%) than in those receiving standard-dose cyclosporine (29.6%), low-dose cyclosporine (19.8%), or standard-dose tacrolimus (23.8%). Allograft survival rates differed significantly among the four groups (P=0.006) and were highest in the low-dose tacrolimus group (99.9%). Serious adverse events were more common in the standard-dose tacrolimus group than in the other groups (51.2% vs a range of 41.4 to 42.3%), although a similar proportion of patients in each group had at least one adverse event during treatment (81.1 to 90.5%). CONCLUSIONS: A regimen of basiliximab, mycophenolate mofetil, and corticosteroids in combination with low-dose tacrolimus may be advantageous for renal function, allograft survival, and acute rejection rates, compared with regimens containing basiliximab induction plus either low-dose cyclosporine or standard-dose tacrolimus or with standard-dose cyclosporine without induction.

The Complications and Their Management after Endovascular Aneurysm Repair for the Treatment of Abdominal Aortic Aneurysms

The management of abdominal aortic aneurysms has dramatically changed since the endovascular aneurysm repair (EVAR) procedure was introduced in 1991 for the treatment of abdominal aortic aneurysm (AAA). EVAR is a less invasive alternative as compared to conventional open repair for abdominal aortic aneurysms. The use of EVAR has increased and is used in fit patients provided that they are regarded as anatomically suitable for a device. Endovascular repair has been shown to decrease the early mortality rate, shorten the hospital stay and decrease blood loss. However, EVAR has a higher rate of graft-related complications and fewer systemic complications. So, the patients who are treated by EVAR need close follow up and diligent graft surveillance. This review of endovascular complications will help physicians gain a thorough understanding of the complications and appropriate managements strategies of AAA.

The Effectiveness of Catheter-directed Thrombolysis for First Line Deep Vein Thrombosis Therapy

PURPOSE: Untreated deep vein thrombosis (DVT) is associated with morbidity and mortality, such as pulmonary embolism and post-thrombotic syndrome. Anticoagulation therapy is efficient for reducing thrombus propagation but is insufficient for clot lysis or preventing post thrombotic syndrome. Current catheter-directed thrombolysis is an important DVT treatment. We compared the outcomes between anticoagulation therapy and DVT catheter-directed thrombolysis. The purpose of this study was to evaluate treatment outcomes in patients with symptomatic DVT who had undergone catheter-directed thrombolysis. METHODS: From January 2003 to January 2009, we retrospectively reviewed 91 patients who had been admitted and treated for DVT in our hospital. We divided 91 patients into two groups according to treatment method; 42 patients (46.2%) were treated with only anticoagulation, and 49 patients (53.8%) were treated with catheter-directed thrombolysis. We compared the results of the two treatments groups. The results included gender, symptom onset, age, location, complications, risk factors, days to improved patient symptoms and patency. All patients underwent Doppler sonography or CT-venography at 3 and 6 months to evaluate venous patency after treatment. RESULTS: 49 patients who underwent catheter-directed thrombolysis for DVT had more symptom-relief days (25.00 days, P<0.001). The 43 patients (88%) of the catheter-directed thrombolysis group showed more complete resolution on Doppler sonography or CT-venography after 6 months (P=0.001). We obtained better clinical outcomes in the catheter-directed thrombolysis group than in the anticoagulation only group. CONCLUSION: Catheter-directed thrombolysis is an effective treatment for acute DVT.

The Graft Outcomes of Living Donor Renal Transplantation according to Gender, Age, and BMI Matching between Donors and Recipients / 대한이식학회지

BACKGROUND: Despite significant advances in immunosuppression, supportive therapies, and operative skills, several factors still compromise long-term graft survival of patients who undergo renal transplantation. This study was designed to evaluate the risk factors influencing graft outcomes of living donor renal transplantation. We matched the recipient and donor age, gender, and body mass index (BMI). METHODS: A total of 527 living renal transplantations were evaluated. The patients were divided into matching groups by donor and recipient age; group 1 (50< or =/; 2, 50< or =/<50; 3, <50/50< or =; 4, <50/<50), gender (A, female/female; B, female/male; C, male/female; D, male/male), and BMI ratio (recipient/donor) (I, <0.8; II, 0.8< or =/<1.3; III, 1.3< or =). We compared 1, 3, 5, and 10 year graft survival and analyzed the donor and recipient variables of age, HLA matching, and acute rejection. RESULTS: The risk factors affecting long-term graft survival were recipient gender, acute rejection rate, and HLA-AB matching. In the groups divided according to donor and recipient age, no statistical difference was observed among the groups, but the 3-5 yr graft survival of group 1 (94.1/86.9%) was much higher than group 2 (86.5/75.6%). In the groups divided according to donor and recipient gender, graft survival in group C was higher than that in the other groups. No statistical difference in acute rejection or graft survival were observed in the groups with different BMI ratios. CONCLUSIONS: Meticulous preoperative donor and recipient matching for living renal transplantation may improve graft survival and expand the donor and recipient pool.

Bilateral Persistent Sciatic Arteries with Unilateral Complication:a Case Report

The sciatic artery is a major artery of the lower limb bulb during the early embryonic period. Its failure to regress is sometimes associated with femoral artery hypoplasia, and therefore, the dominant inflow to the lower extremity is called a persistent sciatic artery (PSA). This anomaly is often associated with a higher rate of aneurysm formation or thromboembolic complications that cause lower extremity ischemia. A 51-year-old man presented with complaints of right calf pain and a several month history of progressive claudication. CT angiography showed bilateral PSAs originating from hypogastric arteries. A long segment of the right PSA showed aneurysmal dilatation and thrombotic occlusion and the superficial femoral artery showed hypoplastic change. Focal segmental occlusion of the right popliteal artery below the knee was seen. He received a right femoro-posterior tibial bypass with a reversed saphenous vein graft. The patient' s postoperative course was uneventful and no complications were observed at 16 weeks follow-up.

Comparison of Quality of Life between Kidney Transplant Patients and Dialysis Patients / 대한이식학회지

BACKGROUND: Kidney transplant patient have a higher quality of life (QOL) and consume fewer health care resources compared to patients on dialysis. The purposes of this study were to compare the QOL in transplant patients and dialysis patients, and to provide basic materials necessary for enhancing their perceived QOL through conducting a survey. METHODS: The subjects of this study were 108 kidney transplant patients performed in our center, from 1990 to 2007, and 46 dialysis patients. These data have been collected from August to September in 2007 by a structured questionnaire about QOL consists of 42 items that assess 6 aspects; Affective state, Social activities, Somatic symptoms, family relationship and financial situation, attitudes toward life, and perceptions of health. We analyzed the collected data through T-test, frequency analysis, and one way ANOVA by employing a statistics package, SPSS 12.0 and we used Cronbach's Alpha Coefficient to verify accuracy and reliability of the measurement tools. RESULTS: Kidney transplant patients were shown statistically significant higher QOL than the dialysis patients, in affective state (P=.000), social activities (P=.001), somatic symptoms (P=.000), attitudes toward life (p=.000), and perceptions of health (P=.000). In family relationship and financial situation (P=.202), transplant patients were shown higher scores than dialysis patients, but there were not statistically significant differences. CONCLUSIONS: We suggest that kidney transplant patients enjoy higher QOL than dialysis patients with statistically significant differences, and there also showed different levels of the QOL according to general characteristics and disease-related features between the two types of patients.