Perfusion Nephropathy in Human Transplants

David Spector, Catherine Limas, James L. Frost, James B. Zachary, Sylvester Sterioff, G. Melville Williams, Ronald T. Rolley, John H. Sadler

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Abstract

To determine whether perfusion preservation affected the structure and survival of kidney transplants, we correlated clinical and histologic data in 77 kidneys biopsied one hour after transplantation. Twenty-one of 36 perfusion-preserved kidneys had a glomerular capillary lesion suggestive of intravascular coagulation. None of 41 kidneys preserved by hypothermia alone had this lesion. Presence of the lesion did not correlate with donor or recipient characteristics, warm or cold ischemia time, H.L.A. match, percentage of preformed lymphocytotoxic antibody titers or perfusion characteristics. Of 21 transplants with the lesion, nine required nephrectomy by one month, and one-month serum creatinine was less than 2.0 mg per deciliter in only three of the remaining 12 transplants. We conclude that perfusion preservation may cause pathologic changes that may adversely affect kidney-transplant function. The causes of the pathologic process remain unclear. (N Engl J Med 295:1217-1221, 1976). The use of perfusion preservation of cadaveric kidneys before transplantation provides time for necessary logistics and compatibility tests, may reduce the frequency of early post-transplant renal insufficiency12and may allow for assessment of donor-kidney function by the monitoring of perfusion characteristics.234It has been suggested, however, that one may be paying a price for these advantages. Anderson, Wyllie and Williams have described structural changes in perfusion-preserved animal and human kidneys,5and Clark et al. have reported decreased one-month and one-year survival rates in transplanted perfusion-preserved kidneys as compared with kidneys preserved by hypothermia alone.6To investigate the effect (or effects).

Original languageEnglish (US)
Pages (from-to)1217-1221
Number of pages5
JournalNew England Journal of Medicine
Volume295
Issue number22
DOIs
StatePublished - Nov 25 1976

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ASJC Scopus subject areas

  • Medicine(all)

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Spector, D., Limas, C., Frost, J. L., Zachary, J. B., Sterioff, S., Williams, G. M., Rolley, R. T., & Sadler, J. H. (1976). Perfusion Nephropathy in Human Transplants. New England Journal of Medicine, 295(22), 1217-1221. https://doi.org/10.1056/NEJM197611252952203