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Cholesterol emboli presenting as acute allograft dysfunction after renal transplantation
I Singh1, P D Killen, A B Leichtman
1Department of Internal Medicine, University of Michigan Medical Center, Ann Arbor 48109-0364, USA.
Journal of the American Society of Nephrology : JASN
|August 1, 1995
Summary
Cholesterol emboli can complicate kidney transplants, especially after starting cyclosporine. Atheroemboli in renal allografts may originate from donor or recipient vessels, requiring vigilance in patients with atherosclerosis.
Area of Science:
- Nephrology
- Vascular Biology
- Transplantation Medicine
Background:
- Cholesterol emboli are a known complication of advanced atherosclerotic vascular disease.
- Renal allograft dysfunction can occur post-transplantation, with various potential etiologies.
- Cyclosporine is a common immunosuppressive agent used in organ transplantation.
Observation:
- A case of acute renal allograft dysfunction in a kidney transplant recipient is presented.
- The dysfunction occurred shortly after initiating cyclosporine therapy and days post-transplantation.
- Renal biopsy confirmed the presence of cholesterol emboli within the allograft's interlobular arteries and glomeruli.
Findings:
- Cholesterol emboli were identified in the renal allograft biopsy of a transplant recipient.
- Atheroemboli can affect renal allografts, potentially arising from either the donor or recipient's vasculature.
- Review of literature identified four prior cases of cholesterol emboli in renal allografts.
Implications:
- Atheroembolic disease poses a risk to renal allograft integrity.
- Identifying atherosclerosis in donor or recipient vessels necessitates heightened awareness for atheroemboli.
- Early recognition and understanding of atheroemboli pathogenesis are crucial for managing transplant complications.