[Acute papillary necrosis in the transplanted kidney]

After a brief literature survey revealing the rarity of the papillary necrosis in transplanted kidneys, the authors report the case of one of their patients, aged 32, transplanted a corpse kidney of a 30-year old male with blood-group compatibility and with coincidence of the two antigens in locus A. Regardless of the increased diuresis of the patient to 3-4 1 within 24 hours, its nitrogen bodies persisted their elevation, necessitating two dialysis. After the second dialysis performed on the tenth day after the transplantation, the patient had very strong pains in the transplantation region, edema around it and a hypovolemic shock. The kidney was explanted and at the examination--necrosis of all papillae in it was established. Blood collection was found round the kidney. The same patient, after that incidence, suffered three successive severe gastrointestinal hemorrhages with shock that necessitated abundant blood transfusions. The cause was a small erosion, about the size of a millet, at the pyloric lumen, result from corticotherapy and favoured by the periodical heparinization during the following hemodialysis. The patient was reanimated and put again on a programmed chroniodialysis.