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대한이식학회> 대한이식학회지> 급성 거부 반응이 이식신의 장기 생존율에 미치는 영향

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급성 거부 반응이 이식신의 장기 생존율에 미치는 영향

The Impact of Acute Rejection on Long-Term Graft Outcome in Renal Allograft Recipient

문장일 ( Jang Il Moon ) , 이창목 ( Chang Mok Lee ) , 김순일 ( Soon Il Kim ) , 김명수 ( Myoung Soo Kim ) , 김유선 ( Yu Seun Kim ) , 박기일 ( Kiil Park )
  • : 대한이식학회
  • : 대한이식학회지 12권1호
  • : 연속간행물
  • : 1998년 06월
  • : 1-7(7pages)

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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 f 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.

UCI(KEPA)

I410-ECN-0102-2009-510-001332762

간행물정보

  • : 의약학분야  > 병리학
  • : KCI등재
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  • : 계간
  • : 1598-1711
  • :
  • : 학술지
  • : 연속간행물
  • : 1987-2020
  • : 1007


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1Fabry 병에서의 신이식 1 예

저자 : 김원 ( Won Kim ) , 고현우 ( Hyeon Woo Koh ) , 박성광 ( Sung Kwang Park ) , 강성귀 ( Sung Kyew Kang ) , 이승렬 ( Seung Ryel Rhee ) , 유희철 ( Hee Chul Yu ) , 조백환 ( Baik Hwan Cho ) , 김민철 ( Min Chul Kim ) , 이광영 ( Kwang Young Lee )

발행기관 : 대한이식학회 간행물 : 대한이식학회지 12권 1호 발행 연도 : 1998 페이지 : pp. 1-5 (5 pages)

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Fabry` s disease is a rare, inborn error, sex-linked disorder of glycosphingolipid metabolism with death occurring from myocardial or renal involvement at 4th or 5th decades. The primary metabolic defect lies in the deficient tissue activity of the enzyme alpha-galactosidase A which results in progressive accumulation of the specific neutral  glycosphingolipids, cerebroside dihexoside(CDH) and cerebroside triihexoside(CTH), within the lysosomes of endothelial, perithelial and smooth muscle cells of the cardiovascular and renal systems predominantly. Clinical manifestations are sequelae of the anatomic 
and physiologic alterations produced by the progressive deposition of glycosphingolipid in the tissues. We report the first case of successful renal transplantation in a patient with Fabry` s disease in Korea. The patient was a 33-year-old male. Fabry` s disease was confirmed by measurement of serum alpha-galactosidase level and renal biopsy. Biopsy finding showed lamellar inclusion bodies on electron microscopy. Galactosidase activity was also markedly decreased. He has been well for 49 months.

2백서 동계신이식 ( Renal Isograft ) 모델에서 Tacrolimus (FK-506) 독성과 -Tocopherol 의 효과

저자 : 홍인철 ( In Chul Hong ) , 유창현 ( Chang Hyun Yoo ) , 정현주 ( Hyeon Joo Jeong ) , 김혜영 ( Hye Young Kim ) , 김순일 ( Soon Il Kim ) , 문장일 ( Jang Il Moon ) , 김유선 ( Yu Seun Kim ) , 박기일 ( Kiil Park )

발행기관 : 대한이식학회 간행물 : 대한이식학회지 12권 1호 발행 연도 : 1998 페이지 : pp. 1-12 (12 pages)

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There have been many reports about oxygen free radical injury as a pathogenetic mechanism of CyA nephrotoxicity, but few reports have investigated the relationship between Tacrolimus(FK-506) ne-phrotoxicity and oxygen free radical injury. Therefore, we decided to evaluate the relationship between Tacrolimus nephrotoxicity and oxygen free radicals, to examine the protective effect of -tocopherol as an antioxidant, and finally to determine the histological changes of these injuries.En bloc resection of the left kidney, left renal artery including a portion of aorta, left renal vein with vena cava, and left ureter including a portion of bladder from male Lewis rats was done, and then preserved in UW solution and stored in the refrigerator at 4oC for 24 hours. After right nephrectomy in the recipients, the harvested organs were transplanted into the right peritoneal cavity using end-to-side anastomoses of the aorta and inferior vena cava between the recipient and donor under a microscope. Also, end-to-end anastomosis of the partly-resected bladders was made between the recipient and donor. After transplantations, rats were divided into 4 groups(I ∼IV). 2 mg of Tacrolimus per kilogram body weight was injected intramuscularly daily into groups II and III. -Tocopherol was injected intraperitoneally daily in the amount of 20 mg/kg from 2 days prior to transplantation in groups III and IV. The control group(I) received the same amount of saline. 5 or 6 rats from each group were sacrificed at 3 days, 7 days, and 14 days after transplantation, respectively. The grafted and native kidneys were removed for histopathologic examination and the measurement of malondialdehyde(MDA) using
a modified TBA method(Ohkawa). Both morphologic renal tubular injury and the increase of MDA due to cold ischemia-reperfusion were highest at 3 days after transplantation, then were alleviated after 7 days. The inhibitory effect of tocopherol to renal tubular damage from cold ischemia-reperfusion began to appear after 1 week, and was distinct 2 weeks after transplantation. The degree of renal tubular damage was the most severe in Tacrolimus nephrotoxicity, and the frequency of tubulointerstitial nephritis increased with the passage of time, as compared with the ischemia-reperfusion injury(group I). With -tocopherol treatment, ischemia-reperfusion injury as well as Tacrolimus nephrotoxicity was decreased or healed 2 weeks after transplantation, and the amount of MDA was markedly decreased after 1 week. In summary, Tacrolimus nephrotoxicity prolonged the duration of acute tubular necrosis and caused tubulointerstitial nephritis in the rat renal isograft model, which may be the result of aggravation of ischemia-reperfusion injury. That the renal damage due to cold ischemia-reperfusion and Tacrolimus administration was reduced by -  tocopherol, indicates that oxidative injury is a pathogenetic mechanism of Tacrolimus nephrotoxicity in this model.

3고령환자의 장기이식

저자 : 김현철 (Hyun Chul Kim)

발행기관 : 대한이식학회 간행물 : 대한이식학회지 12권 1호 발행 연도 : 1998 페이지 : pp. 1-4 (4 pages)

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4간이식 수술에서 T-tube 를 사용하지 않은 담도 재건 술식

저자 : 박연호 ( Yeon Ho Park ) , 장원영 ( Weon Young Chang ) , 조재원 ( Jae Won Joh ) , 김성주 ( Sung Joo Kim ) , 이우용 ( Woo Yong Lee ) , 최성호 ( Seong Ho Choi ) , 이석구 ( Suk Koo Lee ) , 김갑수 ( Gaab Soo Kim ) , 김유홍 ( Yu Hong Kim ) , 박정은 ( Jung Eun Park ) , 조혜술 ( Hye Sool Cho ) ,

발행기관 : 대한이식학회 간행물 : 대한이식학회지 12권 1호 발행 연도 : 1998 페이지 : pp. 1-7 (7 pages)

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Background / Aims: Biliary complication after orthotopic liver transplantation(OLT) continue to be a significant cause of surgical morbidity, occurring in 10 ∼50% of patients. Bile duct obstruction and biliary leaks account for the majority of these complications. An end-to-end choledochocholedochos-tomy( CD) with or without T-tube or a Roux-en-Y choledochojejunostomy(CDJ) have been the standard methods of biliary reconstruction following OLT. We reviewed our experiences of OLT to assess whether or not use of the T-tube leads to increased biliary tract complications. Materials and Methods: From May 1996 to Feb 1998, 34 consecutive liver transplantation in 33 patients were performed at our hospital, including 12 living related liver transplantaiton. Nineteen patients were male and twenty-two patients were adult. The main indication of OLT was hepatitis B virus related cirrhosis(14 cases)in adult and biliary atresia(7 cases) in child. Four ABO incompatible cases were included in living related liver transplant. Biliary tract complications were categorized as bile leak,
stenosis, or obstruction that required therapeutic intervention. Retrospective review of clinical recordings and laboratory findings were done. The median follow up periods was 10 months(range: 3 ∼24 month). Results: The methods of biliary reconstruction in cadaveric liver transplant were CD with T-tube(n=2), CD without T-tube(n=18) and Roux-en-Y HJ(n=2), respectively. In living related liver transplant(LRLT), all 12 cases were reconstructed by Roux-en-Y CDJ without stent. Biliary tract complications were observed in one case of child LRLT patient that biliary fistula occurred at exposed bile duct on cut surface of liver. This patient underwent reoperation for constructed another HJ and progressed without complication. T-tube related complication was observed in one adult patient. T-tube was impinged at cystic duct that obstructed bile flow, intermittently. This patient was treated with insertion of PTBD catheter and removal of T-tube. No other biliary complications were detected in our series. Conclusion: Performing an end-to-end CD without T-tube was a safe and effective method of reconstructing the biliary tract following hepatic transplantation in adult patients, comparing with T-tube splintage method. We concluded that routine placement of the T-tube at hepatic transplantation was considered to some selective cases, but more large scale and long -term studies were needed.

5급성 거부 반응이 이식신의 장기 생존율에 미치는 영향

저자 : 문장일 ( Jang Il Moon ) , 이창목 ( Chang Mok Lee ) , 김순일 ( Soon Il Kim ) , 김명수 ( Myoung Soo Kim ) , 김유선 ( Yu Seun Kim ) , 박기일 ( Kiil Park )

발행기관 : 대한이식학회 간행물 : 대한이식학회지 12권 1호 발행 연도 : 1998 페이지 : pp. 1-7 (7 pages)

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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  f 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.

6혈연간 생체 신이식 환자에서의 미세키메리즘

저자 : 김상준 ( Sang Joon Kim ) , 하종원 ( Jongwon Ha ) , 윤익진 ( Ik Jin Yun ) , 조병선 ( Byung-Sun Cho ) , 박명희 ( Myung Hee Park ) , 안규리 ( Curie Ahn )

발행기관 : 대한이식학회 간행물 : 대한이식학회지 12권 1호 발행 연도 : 1998 페이지 : pp. 1-10 (10 pages)

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Background: Immune tolerance is regarded as the goal of the organ transplantation (TPLx), but the mechanism of tolerance induction remains to be established. Microchimerism (MC) development in long-surviving recipients after solid organ TPLx might be linked to tolerance. Objective: We investigated the development and clinical relevance of donor specific MC in living related renal transplants with good graft function more than 3 years after TPLx. The relationship between MC and mixed lymphocyte reaction (MLR) hyporeactivity was also evaluated. Materials and Methods: Eighteen recipients were included in this study among recipients whose renal function were stable for more than 3 years and have at least one mismatch of HLA DR loci. Donor-specific MC was examined with nested PCR method using HLA DRB1 gene probe in DNA extracted from peripheral blood and forearm skin tissue samples. Mean age at TPLx was 28.9 yrs (range: 13 ∼42 yrs) and mean follow-up period was 67.4 months (range: 36 ∼173 mos). Male to female ratio was 11 :7. Acute rejection occurred in 4 and were reversed with steroid pulse therapy. All donors were alive (parent :8, sibling :9, offspring :1). Immunosuppression regimens were CSA+PDS in 11, AZA PDS in 1, AZA CSA+PDS in 5, and CSA monotherapy in 1. Mean serum BUN/Cr at the point of this study were 22.2 ±6.7 / 1.54 ±0.81 (mg/dL). The sensitivity of nested PCR using HLA DRB1 probe was 1/105 ∼1/106. Results: Donor-specific MC was detected in 6 (33.3%) (5 in blood, 5 in skin tissue). Nested PCR method was more sensitive than single round SSP-PCR method which showed only 2 positive recipients (11.1%). Two of four acute rejection experienced recipients were MC positive. Recipients were divided into two groups according to the follow-up period of 5 years. Two groups showed equal number of MC positivity. MLR was decreased in a group of more than 5 yrs follow-up. However, there was no difference in the decrement of MLR between MC positive and negative groups. Conclusion: MC was detected in 33.3% patients with nested PCR method. Since the MC positivity and MLR hyporesponsiveness shows no relationship, the significance of MC relevant to tolerance is to be determined through further study.

7서울대학교병원에서의 사체 신이식

저자 : 하종원 ( Jong Won Ha ) , 조병선 ( Byung Sun Cho ) , 김상준 ( Sang Joon Kim )

발행기관 : 대한이식학회 간행물 : 대한이식학회지 12권 1호 발행 연도 : 1998 페이지 : pp. 1-12 (12 pages)

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Because of the shortage of living-related donor and social acceptance of brain death, cadaveric renal
transplantation is performed in recent days more frequently than in the past. However, clinical situation
of cadaveric transplantation in Korea is somewhat different from that in western countries and the
outcome is different also. Purpose: We performed this study to know the predicting factors and the survival rate of cadaveric renal transplantation. We also tried to compare our results to that of the western countries to try to
establish the correct therapeutic strategy of cadaveric renal transplantation. Materials and Methods: We analyzed 41 cadaveric renal transplants performed at Seoul National University Hospital from August, 1993 to July, 1997. All patients had follow-up period of more than 6 months.Results: The mean age of recipients was 34.8 years(2 ∼62). All patients except two were primary renal transplants. Male to female ratio was 28 :13. Mean HLA mismatching number was 3.66. The immunosuppressive regimen was triple therapy based on cyclosporine. If delayed graft function(DGF) occurred, cyclosporine was held till renal function became normalized. The incidence of DGF was 17.1%. The overall incidence of biopsy-proven acute rejection was 26.8%(11 cases). Seven cases were diagnosed as acute rejection at protocol biopsies performed at 7 days after renal transplantotion, but had normal renal function. The other 4 cases who had both histologic evidence and clinical features of acute rejection were treated with anti-rejection therapy. The factors affecting graft survival in cadaveric renal transplantation were the acute rejection(p=0.0003) and preservation solution (p=0.0033). The graft
survival rate at 1, 2, 3, 4 year was 86.9%, 86.9%, 80.7%, 80.7%, respectively. Total 6 renal transplants were lost due to 1 chronic rejection, 1 CMV pneumonia, 1 Kaposi` s sarcoma at lung, and 3 sepsis. Conclusion: Our results was comparable to that of the western countries. Careful manipulation of the donors and recipients and prevention of acute rejection are necessary to increase the survival of the cadaveric renal transplants.

8신장이식에 있어서 공여자와 수혜자의 성별이 예후에 미치는 영향

저자 : 황경규 ( Kyung Kyoo Hwang ) , 손창용 ( Chang Yong Sohn ) , 김형태 ( Hyoung Tae Kim ) , 조원현 ( Won Hyun Cho ) , 박철희 ( Choal Hee Park ) , 박성배 ( Sung Bae Park ) , 김현철 ( Hyun Chul Kim )

발행기관 : 대한이식학회 간행물 : 대한이식학회지 12권 1호 발행 연도 : 1998 페이지 : pp. 1-7 (7 pages)

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The role of the donor and recipient gender have been a controversial point in the outcome of renal transplantation and the pathophysiologic mechanisms are not understood clearly. In order to evaluate the effect of gender on the renal graft survival, we reviewed our 400 consecutive living donor renal transplantation. The patients were divided into four groups, Group 1; male donor and male recipient(n=152), Group 2; female donor and male recipient(n=61), Group 3; male donor and female recipient(n=135), and Group 4; female donor and female recipient(n=52). To estimate the transplant outcome between the groups, we analyzed patient and graft survival, acute tubular necrosis, BUN, creatinine and rejection episode for maximum 5 years after transplantation. The level of BUN(34.7 26.4, 19.8 6.4, 30.5 14.6, 23.1 10.5 in group 1,2,3,4 respectively) and serum creatinine(2.62 2.3, 1.48 1.1, 2.24 1.2, 1.65 0.9 in group 1,2,3,4 respectively) were higher in male recipient groups regardless of donor gender. However, donor and recipient gender had no influence on st-graft blood pressure and acute tubular necrosis(p >0.05). Acute rejection episode was predominent at female donor graft than male donor graft(36.4% vs 30.1%). The 5 year graft survival in group 1,2,3,4 were 67.8, 67.2, 60.1, 72.7% and patient survival were 76.9, 75.6, 72.6, 80.5% in their orders. These results suggest that donor and recipient gender might play a role in the outcome of renal transplantation. The mechanism of these results must be analyzed by further evaluation using larger patient group.

9장기이식과 의료윤리 :국내외 병원의 장기이식 현황과 윤리지침 제안을 위한 연구

저자 : 한성숙 ( Sung Suk Han ) , 황경식 ( Kyung Sig Hwang ) , 맹광호 ( Kwang Ho Meng ) , 이동익 ( Dong Ik Lee ) , 엄영란 ( Young Rhan Um ) , 구영모 ( Young Mo Koo )

발행기관 : 대한이식학회 간행물 : 대한이식학회지 12권 1호 발행 연도 : 1998 페이지 : pp. 7-22 (16 pages)

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Aims: This study was done to develop an ethical guideline for organ transplatation, a life-saving treatment which helps improve the quality of life. Methods: This study begins with a survey of the Korean current state of affairs concerning organ transplantation. This study used a survey questionnaire and received responses from 31 hospitals out of 45 hospitals where organ transplantation are being done. After this survey, followed by a discussion of ethical considerations in arranging organ transplants. Before proposing an ethical guideline, this study discusses a series of interesting ethical issues in transplanting(both living and cadaveric)organs including ethical foundations of organ transplantation, distributive justice and matters of donor` s consent in organ transplatation. Results: The foremost research for this study boils down to a survey paper titled, "An Analysis of the Current State of Affairs Concerning Organ Transplantation and Ethical Considerations in Domestic and International Hospitals." Based upon data collected from various hospitals, this work analyzes items, such as the frequency and types of organs transplanted in a hospital, the existence of organ transplant coordinator, the performance of the hospital ethics committee, and ethical considerations in obtaining consents from the living donor. Although thousands of organs are annually transplanted in domestic hospitals, virtually none of them are found to meet ethically proper standards. The paper points out the need to institutionalize a nationwide cadaveric organ distribution organization like UNOS(United Network for Organ Sharing) in the U.S., and proposes to stretch out the national health insurance to extensively cover transplanting expenses. "The Ethical Foundation of Organ Transplantation", the author counts three key ethical principles in organ transplantation: the principle of respect for autonomy; the principle of beneficence; and the principle of justice. He argues that in cases of living donor no principle should take precedence over
the principle of respect for autonomy and thus it is very important for a hospital to obtain the donor` s consent. As for cadaveric organ transplantation, he holds reservation because he is worried that serious shortage of organs for transplantation in conjunction with pure utilitarian considerations could change the definition of death so that the brain death gains more popularity than ever. In addition, the author claims that the proponent of organ transplantation must distinguish the moral dimension of the discussion from the legal one because otherwise she would hardly be able to defend herself from the slippery slope argument against organ transplantation. This paper concludes with a note that we must implement restrictions to avoid undesired effects if organ transplantation could ever be justified. "A Discussion of Distributive Justice in Organ Transplantation" comprises two parts. The first half delineates above mentioned ethical principles in the context of organ transplantation, while the second half goes generally over the UNOS Point System. This work is focused entirely upon cadaveric organ transplants, because the vast majority of organs available for transplants comes from cadavers and the number is still increasing. The UNOS allocates cadaveric organs based upon both medical and justice criteria. Following are summaries of the UNOS policy on organ distribution. Every potential recipient of organ transplants must be listed on the UNOS computer system waiting list. Allocation of cadaveric kidneys consider factors such as waiting time, six antigen match, panel reactive antibody, blood group and age. The UNOS Point System allocates livers to the local patients first, followed by regional and national patients respectively, in order to limit ischemic time. A recipient of liver transplant belongs to one of five(0 ∼4) medical status levels where status 4 is the most medically urgent. At the regional and n

10백서의 FK506 신독성에서 혈관내 endothelin, TGF-beta 및 PDGF 의 표현

저자 : 정현주 ( Hyeon Joo Jeong ) , 김유선 ( Yu Seun Kim ) , 홍인철 ( In Chul Hong )

발행기관 : 대한이식학회 간행물 : 대한이식학회지 12권 1호 발행 연도 : 1998 페이지 : pp. 23-28 (6 pages)

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The vascular lesions in FK506 nephrotoxicity are similar to cyclosporine A, in which mediators related
to vascular constriction and thickening such as endothelin, TGF-beta and PDGF may have some roles.
Their expressions may be different in terms of degree and time sequence as well as overlapping ischemia,
which made us to perform this experiment. Male Sprague Dawley rats received FK506 daily at a dosage of 2 mg/kg by intramuscular route for 4 weeks at maximum and were sacrificed 3 days, 1, 2 and 4 weeks after the initiation of the study, respectively. The control rats received saline. Renal ischemia was  induced by occluding the left renal artery for 45 minutes and rats were sacrificed up to 2 weeks after reperfusion. Kidneys were processed for light microscopy and stained with PAS method and with antibodies against endothelin, TGF-beta and PDGF. The number of juxtaglomerular apparatus(JGA) and arterioles positive for each antibody was counted under light microscope and was expressed as mean+-S.D per mm2 cortex. In FK506 treated rats, JGA and afferent arterioles were prominent with PAS positive granules, which was extended proximally to interlobular arteries with increased duration of FK506 treatment. With increasing duration, TGF-beta reactivity was increased in afferent arterioles. However, no such results were shown in cases of PDGF and endothelin. Renal ischemia itself increased vascular TGF-beta as
well as endothelin and PDGF reactivities. Renal ischemia in FK506 treated rats further upregulated the
expression of these markers in a similar distribution. However, the expression of endothelin was mostly
found in endothelial cells of peritubular and glomerular capillaries. PAS staining was decreased in
ischemic kidneys regardless of FK506 treatment.
These results indicate that FK506 toxicity was comparable to CsA toxicity. Since expression levels
of endothelin, TGF-beta and PDGF were increased in ischemic kidney, it might be helpful to prevent
ischemic damage as well as to hinder secretion of these factors in order to reduce FK506 nephrotoxicity.

12
주제별 간행물
간행물명 수록권호

KCI등재

대한이식학회지
34권 3호 ~ 34권 3호

KCI후보

한국정맥경장영양학회지
12권 1호 ~ 12권 1호

KCI등재

대한이식학회지
34권 2호 ~ 34권 2호

KCI등재

대한이식학회지
34권 1호 ~ 34권 1호

KCI등재

대한이식학회지
33권 4호 ~ 33권 4호

KCI후보

한국정맥경장영양학회지
11권 2호 ~ 11권 2호

KCI등재

대한이식학회지
33권 3호 ~ 33권 3호

KCI후보

한국정맥경장영양학회지
11권 1호 ~ 11권 1호

KCI등재

대한이식학회지
33권 2호 ~ 33권 2호

KCI등재

대한이식학회지
33권 1호 ~ 33권 1호

KCI후보

한국정맥경장영양학회지
10권 2호 ~ 10권 2호

KCI등재

대한이식학회지
32권 4호 ~ 32권 4호

KCI등재

대한이식학회지
32권 3호 ~ 32권 3호

KCI후보

한국정맥경장영양학회지
10권 1호 ~ 10권 1호

KCI등재

대한이식학회지
32권 2호 ~ 32권 2호

KCI등재

대한이식학회지
32권 1호 ~ 32권 1호

KCI후보

한국정맥경장영양학회지
9권 2호 ~ 9권 2호

KCI등재

대한이식학회지
31권 4호 ~ 31권 4호

한국정맥경장영양학회 학술발표논문집
2017권 0호 ~ 2017권 0호

KCI등재

대한이식학회지
31권 3호 ~ 31권 3호
발행기관 최신논문
자료제공: 네이버학술정보
발행기관 최신논문
자료제공: 네이버학술정보

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