Cold lymphocytotoxins: an important cause of acute tubular necrosis occurring immediately after transplantation.
Cold-reactive lymphocytotoxins, present in some renal-transplant recipients, may be an important cause of the acute tubular necrosis (ATN) that commonly occurs immediately after transplantation. In a study of transplantation of optimally preserved cadaveric kidneys obtained from heart-beating donors, ATN was found in 10 of 17 recipients with cold antibodies and in only 1 of 21 recipients without such antibodies. Warming of the allograft after completion of anastomosis significantly reduced the incidence of ATN at 18% in recipients with cold antibodies. When pairs of reicpients with cold antibodies were transplanted with identically preserved cadaveric kidneys from single donors ATN was observed only in recipients whose donor kidney was not warmed. ATN may result from antibody-medicated damage to vascular endothelial cells during the brief period when the recipient's blood starts flowing into a "cold" allograft.
D058186:Acute Kidney Injury / Q000209:etiology*; D000961:Antilymphocyte Serum / Q000032:analysis*; D003080:Cold Temperature; D006801:Humans; D007075:Immunoglobulin M / Q000032:analysis; D007668:Kidney / Q000276:immunology; D016030:Kidney Transplantation; D007683:Kidney Tubular Necrosis, Acute / Q000209:etiology* / Q000276:immunology; D014021:Tissue Preservation / Q000379:methods; D014184:Transplantation, Homologous
D000961:Antilymphocyte Serum; D007075:Immunoglobulin M