USCAP EVENING RENAL PATHOLOGY SPECIALY CONFERENCE
ATLANTA
Wednesday March 7, 2001
Moderator V. D'Agati

A 39-year-old woman received a living-related kidney transplant after a long history of medullary cystic kidney disease. Immunosuppression included Solu-Medrol, Imuran and Cyclosporine A. She was discharged seven days after transplantation with a creatinine of 1.5. Additional drugs included Acyclovir and Bactrim. Two days after discharge she presented with decreased urine output. She was afebrile, blood pressure was normal, the graft was palpable and there was edema of the lower extremities. The serum creatinine was 3.1, WBC 5700, hemoglobin 6.4 and platelet count 117,000, bilirubin 0.5, potassium 7.1, and serum albumin 2.6. Ultrasound demonstrated good flow to the kidney and she was treated with OKT3 for presumed acute rejection. However, the creatinine continued to rise to 5.8 and a renal biopsy was performed on the 3rd hospital day. On the fifth hospital day the creatinine was 9.2, platelet count 62,000 and hemoglobin 5.8.

Five kodachrome slides; no IF or EM.