An autopsy case of bacterial septic shock 12 years following ABO-incompatible renal transplantation.
We report the case of an ABO-incompatible kidney transplant recipient who died suddenly following a good transplant course of 12 years. For 10 years after transplantation, the graft function had been stable (s-Cr: 1.0-1.5 mg/dL), although chronic hepatitis C had developed, with elevation of transaminase. In the 11th year, he was admitted into the hospital with low-grade fever and general fatigue. Jaundice and anaemia progressed, and he died 2 months after admission. The autopsy diagnosis was: (1) post-renal transplantation state, (2) phlegmonous enterocolitis with septic infarction, (3) cellulitis and necrotic myositis, and (4) sepsis. The transplanted kidney graft showed well-preserved glomeruli and tubules, corresponding to chronic allograft nephropathy (CAN) grade Iota (ci1, ct1, cv1), according to the Banff classification. The pathological changes observed in this long-surviving ABO-incompatible kidney graft were similar to those of an ABO-compatible graft, although its degree was milder.
Okamoto
M
M
Department of Transplantation and Regenerative Surgery, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan.
Omori
Y
Y
Ichida
M
M
Nobori
S
S
Higuchi
A
A
Kadotani
Y
Y
Akioka
K
K
Itoh
K
K
Fushiki
S
S
Yoshimura
N
N
D000017:ABO Blood-Group System; D000328:Adult; D001344:Autopsy; D017809:Fatal Outcome; D006650:Histocompatibility Testing; D006801:Humans; D007668:Kidney / Q000473:pathology*; D007678:Kidney Glomerulus / Q000473:pathology; D016030:Kidney Transplantation / Q000473:pathology*; D007684:Kidney Tubules / Q000473:pathology; D008297:Male; D012772:Shock, Septic / Q000473:pathology*; D013997:Time Factors
D000017:ABO Blood-Group System