8 cases of membranous glomerulonephritis (MG) after renal transplants (RT) are presented; one being a recurrence of the original disease and the other 7 due to a different cause of renal insufficiency. The total incidence of MG after transplantation was 1.63%; 1.39% being the incidence of MG of new cases. Only 1 patient showed decrease of renal function and in this case the MG was accompanied by chronic rejection lesions. There was no sign of neoplasias nor drugs producing MG. As far as chronic infections are concerned, only one patient showed B antigen and it was not observed during the immunofluorescent test in the biopsy. 6 patients had urological complications after the renal transplant (3 cases of urinary fistula; 2 cases of obstructive uropathy; 1 case of short ureter). 2 patients experienced the start of hemodialysis due to focal and segmentary glomerulosclerosis. The beginning of proteinuria commences between 2 and 23 months after the RT (median 13,0 +/- 7,5 moths); with a range of between 2.0 and 12.0 gr/day (median: 6.8 +/- 3,2 Z gr/day), this being nephrotic in 4 cases. Proteinuria improved 1 case, and persisted in the other patients at the same level registered previous to the diagnosis. MG is a non-frequent complication or RT and is usually benign. Patients with post-transplant urologic complications could be considered to have a higher risk of developing a MG "de novo".

Adolescent↗

PubMed1990

[Antibiotic prophylaxis before kidney transplantation].

The effectiveness of antibiotic prophylaxis was evaluated in the immediate postoperative period of renal transplantation (RT). Before RT, the patients were randomly assigned to one of the following groups: 1) cefotaxime (intravenous infusion of 1 g one hour before the operation). 2) Ceftriaxone (1 g i.v. given in a similar way). 3) Control (without antibiotics). Patients who required antibiotic therapy during the first 3 postoperative weeks were excluded. 20 recipients of cadaveric renal grafts were included in each group. There were 39 males and 21 females with a mean age of 39.9 years. One patient from the cefotaxime group (5%), 2 from the ceftriaxone group (10%) and 2 from the control group (10%) developed infection of the surgical wound, all due to grampositive organisms. 19 patients had urinary tract infections: 7 from the control group (35%), 7 from the cefotaxime group (35%), and 5 from the ceftriaxone group (25%). The development of wound infection was not correlated with urea, creatinine, hemoglobin or total protein levels, or with urinary tract infection or fistula, diabetes or fever. The mean packed red cell volume of the patients who developed wound infection was 24.7 +/- 1.2 vs 28.6 +/- 6.6 in those who did not (p less than 0.01). All patients with visible hematoma and 3 of 10 with perirenal blood collection had wound infection. It was concluded that antibiotic prophylaxis for renal transplantation was useless in our patients.

Adult↗

PubMed1990

Kidney transplantation from anencephalic donors. Report of 5 cases and a review of the literature.

The results of five 'en bloc' kidney transplants from 5 anencephalic newborns are reported. The receptors were 8-50 years old. The graft survival 12 months after transplantation was 60%. The average plasma creatinine level the 1st month after transplantation was 4.0 +/- 0.8 mg/dl, after 6 months 1.5 +/- 0.8, and is currently 1.2 +/- 0.6 mg/dl. The follow-up time ranged from 17 to 55 months (mean 30.3 +/- 17.5 months). Two grafts were lost during the early posttransplantation period (due to arterial thrombosis and vascular rejection, respectively); the other grafts are still functioning. Two grafts showed initial oliguria. All of the patients required hemodialysis or peritoneal dialysis for 5-60 days (mean 22.5 +/- 21.4 days). The time of cold ischemia ranged from 15 to 35 h (mean 25.6 +/- 7.7 h). The literature published on the subject is reviewed, and it is concluded that anencephalic donors are an acceptable option for transplantation.

Adolescent↗

PubMed1989