[Acute papillary necrosis in transplanted kidney]

After a short literature survey, indicating the rarity of acute papillary necrosis in transplanted kidneys, the authors reported one of their patients, aged 32, with transplanted dead body kidney from a male, aged 30, with blood group compatibility and compatibility of two antigens in locus A. Two hemodialysis were necessiated because of acute tubular necrosis in the transplant. After the second one, performed 10 days after the transplantation, the patient felt very strong pains in the region of the transplant, edema around it and hypovolemic shock. The kidney was explanted and necrosis of the majority of the papillae in it--established, and around it--blood collection. After that incidence, the patients had three severe gastrointestinal hemorrhages with shocks, that necessitated profuse transfusion of blood. Their cause was a small erosion, about a lentil seed, at the pyloric opening, resulting from the cortico-therapy and periodic heparinization for dialysis. The patients was reanimated and returned to programmed chroniodialysis. The possible causes for papillary necrosis are discussed, most acceptable being two of them them--urostasis from 1200 ml urine in the urinary bladder, that required catheterization before the incidence and/or compression and ischemia of the transplanted kidney by the blood collection around it.