Detection of urinary fibrin-fibrinogen degradation products in kidney transplantation

Several techniques are used to detect rejection episodes in renal transplants; complexity renders these tests impractical for clinical use in most cases. This paper reports the results obtained in the study of urinary FDP, by counterimmunoelectrophoresis, in 50 healthy subjects and in 360 consecutive samples from 18 renal transplant recipients; urine specimens were examined daily for periods of time of up to 60 days post transplant. Endogenous creatinine clearance levels were also quantified. Our findings show that while in normal subjects negative tests were always obtained in kidney transplant patients, increased FDP excretion was found, with peak levels observed at least 24 hours before the decrease of glomerular filtration rates and clinical manifestations of acute rejection which subside with immunosuppression. Finally, urinary FDP excretion in the oliguric phase of post transplant acute renal failure was similar to that of patients where kidney transplants functioned without any evidence of rejection.