We admitted a 53-year-old male for deceased-donor kidney transplantation. He had been on continuous ambulatory peritoneal dialysis (CAPD) for 52 months. His native kidney disease was unknown. He was doing well on CAPD and had never experienced peritonitis. We did not have a measurement of panel reactive antibodies prior to his transplant surgery. The kidney was placed into the right inguinal fossa and his peritoneal dialysis (PD) catheter was leftin place. Since he was thought to be immunologicaLly high risk, we administered rabbitantithymocyte globulin (ATG) ata dose of 3 mg/kg body weight as an induction agent, along with 1 g methylprednisolone and mycophenolate mofetil. No surgical complications occurred; however, his urine output was not adequate. Doppler ultrasound ruled out urinary tract obstruction and renalvein thrombosis. Tc-99m DTPA scintigraphy revealed a normally perfused kidney but concentration and excretion were diminished considerably. Percutaneous allograft biopsy was consistent with acute humoral rejection.
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