Acute cellular rejection occurring on the first day after living-related renal transplantation: a case report
| Autor: | Takashi Kenmochi, Kensuke Joh, Kazunori Ohtsuki, Naotake Akutsu, Michihiro Maruyama, Hiroshi Kitamura, C. Iwashita, Kenichi Saigo |
|---|---|
| Rok vydání: | 2006 |
| Předmět: |
Graft Rejection
Male Pathology medicine.medical_specialty Lymphocyte Biopsy Prednisolone Kidney Peritubular capillaries ABO Blood-Group System chemistry.chemical_compound Directed Tissue Donation medicine Living Donors Humans Transplantation Creatinine medicine.diagnostic_test business.industry Middle Aged medicine.disease Kidney Transplantation Cellular infiltration medicine.anatomical_structure Methylprednisolone chemistry Pulse Therapy Drug Acute Disease business Infiltration (medical) medicine.drug |
| Zdroj: | Clinical transplantation. 20 |
| ISSN: | 0902-0063 |
| Popis: | The patient was a 52-year-old man who received an ABO-compatible but non-identical living-related renal graft from his wife. The graft started to function immediately and the urine output rate was over 100 mL/h. However, this was gradually decreased within 12 h after transplantation. On day 2 post-transplant, the urine output almost stopped. A biopsy specimen revealed lymphocyte dominant cellular infiltration in the interstitium with mild tubulitis (according to Banff's schema grade Ia) and no C4d deposition in peritubular capillaries. Immunohistochemistry disclosed T-cell infiltration. The patient responded to a course of steroid pulse therapy (five days of 500 mg of methylprednisolone). The urine output gradually increased and the level of serum creatinine gradually decreased to 1.0 mg/dL. These clinical and histological findings strongly suggested acute cellular rejection. Acute cellular rejection occurring within 24 h post-transplant is extremely rare. In the present case acute cellular rejection occurred within the first day after living-related renal transplantation and was strongly suspected from histopathological findings in the allograft biopsy specimen. |
| Databáze: | OpenAIRE |
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