Dong Kee Kim

Ratio of donor kidney weight to recipient bodyweight as an index of graft function

Reduced renal mass or mismatching kidney size are risk factors for chronic allograft nephropathy. We assessed the effect of mismatching donor kidney weight and recipient bodyweight on renal graft function in 82 live donor kidney transplant recipients who did not have acute rejection. We calculated the donor kidney weight to recipient bodyweight ratio, and established the relation between this ratio and renal indices with a mixed model regression. We showed that recipients with a high ratio had better graft function.

Evidence that the ratio of donor kidney weight to recipient body weight, donor age, and episodes of acute rejection correlate independently with live-donor graft function.

Background. We demonstrated that higher donor kidney weight-to-recipient body weight (KW/BW) ratio showed better graft function in acute rejection-free renal recipients. Methods. We investigated the impacts of KW/BW ratios on the graft function including acute rejection and donor’s age in 259 live-donor renal recipients. Renal parameters were measured yearly. Correlations between the variables and each parameter were assessed by mixed regression and analysis of variance. Results. Renal function showed a positive correlation with the KW/BW ratio, but an inverse correlation with the rejection episodes and donor’s age. The regression slope for serum creatinine or creatinine clearance by these covariants was consistent each year. On comparing the lower KW/BW ratios (<3.0) with higher ratios (≥4.5), the higher was associated with better graft function. Increased donor’s age was associated with worse graft function. Conclusions. KW/BW ratio, donor’s age, and the number of acute rejections are independent covariants for graft function.

Chronologically different impacts of immunologic and non-immunologic risk factors on renal allograft function

Abstract:  Introduction:  Upon analysis of the risk factors affecting renal graft survival and function, the time‐dependent effects of each risk factor should be differentiated from their net effects. To evaluate the chronologically different impacts of risk factors on graft renal function, we reviewed 390 recipients who received a kidney from 1‐haplotype‐matched living‐related donors.

The Efficacy of the Ultrasonographic Screening Test for Early Detection of Hepatocellular Carcinoma and Risk Factors of HCC in Korea

To evaluate the effectiveness of screening for early detection of hepatocellular carcinoma (HCC) in Korea, the data of 12 899 patients who had ultrasonography (US) for reasons of chronic liver diseases were collected into a database program from 1990 to 1998. The risk factors of HCC were also studied. A total of 4 025 patients were enrolled who had repeated US. The male-to-female ratio was 2:1 and the age distribution was mostly between the fifth and seventh decades; 188 patients were diagnosed with HCC during follow-up (mean, 27 months), and the annual detection rate was 2.0%. The detection rate of small HCC (≤3 cm in diameter) was 67.6%. The tumor size detected by screening within a 6-month interval was significantly smaller than at a longer interval (2.9 cm vs. 3.6 cm; P > .01). The smaller the tumor was at detection, the longer the survival time. Only 28.2% of HCC patients had an elevated serum alpha- fetoprotein (aFP) level above 400ng/ml. The risk of HCC development during follow- up was higher among patients with liver cirrhosis (10.7%) than chronic hepatitis (4.0%) and higher for hepatitis C (8.8%) than hepatitis B (4.7%) and non-B, non-C hepatitis (non-BC, 3.7%). No cases of HCC developed at less than 30 years old, and there were none at less than 40 years among hepatitis C and non-BC. In conclusion, US screening within a 6-month interval is beneficial to high-risk patients over 40 years old through the early detection of HCC and prolonged survival. According to the risk factors, the necessity for a screening test and the proper interval should be reconsidered.