Intrarenal manometry in the diagnosis of acute rejection superimposed on XXXX in renal transplantation.

@entity1 @entity4295 @entity1458 @entity205 @entity810 @entity230
We used fine-needle intrarenal manometry as a guide for detection of acute rejection superimposed on protracted oliguric @entity4295 occurring in the postoperative course of @entity1 renal transplantation. We followed intrarenal pressure (IRP) in 31 @entity1 who received 32 renal transplants, 12 from living related donors and 20 from cadaveric donors. There were 19 rejection episodes and 10 episodes of transient @entity205 (CyA) nephrotoxicity. Nine @entity1 had posttransplant @entity810 . Levels of IRP (mmHg) in acute rejection were (mean +/- SD) 48.6 +/- 11.1, significantly higher (p less than 0.001) than the levels in CyA nephrotoxicity (28.2 +/- 5.21), @entity4295 (24.5 +/- 5.5) and normal functioning grafts (26.4 +/- 6.63). Antirejection treatment was associated with return to normal of IRP after 10 days. Intrarenal manometry was performed routinely ever 2-3 days in @entity1 who had postoperative @entity810 . Increments in IRP were detected on the 7-10th postoperative day in 7 @entity1 who had 10-25 days of post-transplant @entity1458 . Renal biopsy findings were compatible with acute rejection, and the @entity1 responded to intravenous bolus of @entity230 . We suggest that fine-needle intrarenal manometry is a reliable test for the detection of acute rejection in circumstances when traditional parameters of altered renal function cannot be evaluated.
