脳死体ドナー腎を用いた献腎移植の1例

Abstract

We experienced a case of cadaveric kidney transplantation from a heart-beating donor, a 23-year-old man who became brain dead after a traffic accident. The recipient, a 39-year-old man, had been receiving regular hemodialysis since 1990, was admitted to our hospital on June 14, 1999. The number of human lymphocyte antigen mismatches was 3. The left kidney of the donor was transplanted to the right iliac fossa of the recipient 6 hours 28 minutes after the start of in situ cooling of the kidney. For the purpose of immunosuppressive induction, tacrolimus, azathioprine, antilymphocyte globulin, methylpredonisolone and deoxyspergualin were administered. Immediate function was obtained, moreover, the serum creatinine level of the recipient was normalized without hemodialysis. The histopathological examination of the transplant kidney biopsied 1 hour after transplantation revealed little damage of renal tubules. Since no rejection episode was recognized, the patient was discharged on the 48th day after transplantation. This is the third case of cadaveric kidney transplantation from a heart-beating donor after enforcement of the law concerning organ transplantations in Japan.