[A case of accelerated acute rejection in kidney transplantation rescued by plasma exchange].
A 30-year-old female received living donor kidney transplantation from her mother. The surgical procedure was uneventfully performed and urine output was observed a few minutes after reperfusion. However, 24 hours after the surgery, the urine volume rapidly decreased with worsened renal blood flow as determined by Doppler ultrasonography, diagnosed as accelerated acute rejection (AAR). Plasma exchange (PE) combined with therapies including administration of steroids and OKT3 dramatically improved the renal status, resulting in maintenance of good renal function (serum Cr; 1.5 mg/dl) even after 18 months PE was considered as a powerful tool for AAR, and the literature was reviewed.
Okinami
Takeshi
T
The Department of Urology, Kyoto University Hospital.
Yamamoto
Shingo
S
Yoshida
Hiroshi
H
Ito
Noriyuki
N
Kamoto
Toshiyuki
T
Ogawa
Osamu
O
D000208:Acute Disease; D000328:Adult; D003524:Cyclosporins / Q000008:administration & dosage; D005260:Female; D006084:Graft Rejection / Q000628:therapy*; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D007668:Kidney / Q000503:physiopathology; D016030:Kidney Transplantation; D016853:Muromonab-CD3 / Q000008:administration & dosage; D010951:Plasma Exchange
D003524:Cyclosporins; D007166:Immunosuppressive Agents; D016853:Muromonab-CD3