Identification and treatment of XXXX -associated allograft @entity715 .

@entity1 @entity14309 @entity205 @entity1381 @entity230 @entity715
Endothelial injury associated with @entity205 (CSA) therapy in the absence of rejection has resulted in irreversible @entity715 . Indium 111 (111In)-labeled platelet scanning is an effective way to identify those transplants that are at risk for acute loss. Two hundred prospective 111In scans were obtained (100 on allografts with normal function and 100 with transplant dysfunction of all causes). 111In scans in @entity1 with dose-dependent CSA nephrotoxicity (N = 58) and biopsy proved acute rejection (N = 22) were negative. Grossly abnormal scans (three to eight times greater than hepatic uptake) were noted in nine recipients identified as having a @entity1381 associated with CSA use. Accelerated allograft functional loss was irreversible in six @entity1 despite stopping CSA, systemic anticoagulation, increased @entity230 and antilymphocyte globulin, and infusion of fresh-frozen plasma. Three @entity1 with grossly positive 111In scans and clinical and laboratory parameters consistent with this syndrome were treated with cessation of CSA and intra-arterial infusion of streptokinase into the renal allograft followed by systemic heparinization. Normal transplant function was regained and continues at 1, 7, and 8 months after transplant. 111In-labeled platelet scanning can noninvasively identify this syndrome of @entity14309 and allow for early therapy to reverse it. Intrarenal arterial streptokinase therapy is a successful way to treat acute @entity14309 .
