Mujagic M, Montandon A, Zimmermann A
Schweiz Med Wochenschr. 1978 Nov 11;108(45):1773-82.
Early acute rejection with oligo-anuria was observed in 9 cases among 103 cadaver kidney allografts transplanted between January 1969 and May 1977. According to our experience this type of rejection crisis occurs between the 6th and 9th day after transplantation. It is characterized by a typical clinical course. The beginning is acute with high fever and swelling of the graft, followed by oligo-anuria demanding treatment with hemodialysis. In all cases except one there was total restoration of graft function after an oligo-anuric period of 4--16 days. The late prognosis was good in 5 cases. The other 4 patients lost their grafts during the first 4 months after transplantation as a consequence of a second irreversible rejection reaction. The pathogenesis of this early acute and reversible failure of the transplant is discussed, together with the histologic findings in one case.
1969年1月至1977年5月间移植的103例尸体肾同种异体移植中,有9例观察到早期急性排斥伴少尿或无尿。根据我们的经验,这种类型的排斥危机发生在移植后的第6至9天。其特点是典型的临床病程。开始时为急性,伴有高热和移植肾肿胀,随后出现少尿或无尿,需要进行血液透析治疗。除1例病例外,所有病例在经历4至16天的少尿或无尿期后,移植肾功能均完全恢复。5例患者后期预后良好。另外4例患者在移植后的前4个月内由于第二次不可逆的排斥反应而失去了移植肾。本文讨论了这种早期急性可逆性移植失败的发病机制,并结合1例病例的组织学发现进行了阐述。