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Lymphatic visualization during renal transplant rejection.

J T Cuttino, R L Clark, S R Mandel

    Investigative Radiology
    |July 1, 1978
    PubMed
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    Renal lymphatic visualization during canine allograft rejection indicates immune injury. Lymphatic filling correlates with rejection severity, highlighting their role in managing edema due to microvascular damage.

    Area of Science:

    • Nephrology
    • Immunology
    • Vascular Biology

    Background:

    • Allograft rejection involves complex immune responses and vascular changes.
    • The role of the renal lymphatic system in allograft rejection is not fully understood.
    • Edema is a common complication in renal allografts during rejection.

    Purpose of the Study:

    • To investigate intrarenal microlymphatic filling during canine allograft rejection.
    • To correlate lymphatic visualization with the pathophysiologic state of the allograft.
    • To explore the mechanism of lymphatic filling in the context of immune injury.

    Main Methods:

    • Microangiographic and histologic study of unmodified canine allografts.
    • Assessment of lymphatic visualization following arterial perfusion.

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  • Correlation of lymphatic filling extent with allograft pathology and rejection stage.

    • Main Results:

    • Prominent intrarenal lymphatic visualization was observed during early allograft rejection.
    • Lymphatic filling correlated with increased microvascular and histologic alterations.
    • In late rejection with cortical necrosis, lymphatic filling became less evident.
    • Human specimen demonstrated renal lymphatic visualization post-arterial perfusion during rejection.

    Conclusions:

    • Intrarenal lymphatic visualization during rejection is linked to microvascular integrity loss and contrast extravasation.
    • Lymphatics serve as an alternate drainage route for interstitial edema caused by immune injury.
    • Lymphatic filling patterns reflect the dynamic pathophysiologic changes in rejecting renal allografts.