title: Renal allograft nephrectomy: comparison between clinical and pathological diagnosis.
abstract: OBJECTIVE
  The most common complication of renal transplantation is allograft dysfunction, which in some cases leads to graft loss. The role of graft nephrectomy in the management of transplant failure is controversial. The procedure remains associated with a significant morbidity and also mortality. Our main purpose was the comparison between clinical and pathological diagnosis of graft nephrectomy.
  
  
  METHODS
  The documents of 88 patients who admitted for graft nephrectomy in Shariaty hospital for the last 25 years were reviewed. Slides of graft pathology were revised by an individual nephropathologist. Data was analyzed by SPSS 18 using ANOVA and Chi-square tests.
  
  
  RESULTS
  THE PERCENTAGES OF CLINICAL DIAGNOSES FOR THE GRAFT NEPHRECTOMY ARE: chronic rejection (38%), graft infection (26%), gross hematuria (10%), acute rejection (10%), accelerated rejection (8%), hyper-acute rejection (4%) and thrombosis of the renal artery (4). On the other hand, the pathological diagnoses are: necrosis concomitant with thrombosis (35%), only necrosis (26%) and 5 (3) concomitant with 4 (3) in 16% of cases that means severe interstitial atrophy and fibrosis adjacent with acute cellular rejection and intramural vasculitis.
  
  
  CONCLUSIONS
  Pathology included necrosis in about half of the graft nephrectomized patients. If the panel reactivity test is negative preoperatively, and there is no absolute indication for the operation, one may abstain from graft nephrectomy to save the patient, the morbidity and even the mortality of the procedure. On the other hand, the advantages of leaving the graft in situ are erythropoietin production, hydroxylation of calcidiol and maintenance of some residual diuresis.
authors.affiliation: Department of Urology, Rafsanjan University of Medical Sciences, Rafsanjan, IR Iran.
authors.forename: Ali
authors.initials: A
authors.lastname: Panahi
authors.affiliation: Department of Psychiatry, Rafsanjan University of Medical Sciences, Rafsanjan, IR Iran.
authors.forename: Reza
authors.initials: R
authors.lastname: Bidaki
authors.affiliation: Isfahan University of Medical Sciences, Isfahan, IR Iran.
authors.forename: Seyyed Mohammad Mahdy
authors.initials: SM
authors.lastname: Mirhosseini
authors.affiliation: Department of Urology, Tehran University of Medical Sciences, Tehran, IR Iran.
authors.forename: Darab
authors.initials: D
authors.lastname: Mehraban
keywords: Clinical Laboratory Techniques; Kidney Failure, Chronic; Transplantation, Homologous