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A case of acute rejection with adenovirus infection after ABO‐incompatible kidney transplantation
Author(s) -
Komiya Toshiyuki,
Goto Norihiko,
Takeda Asami,
Horike Keiji,
Onoda Hiroshi,
Sakai Kaoru,
Kitamura Ken,
Yamamoto Keiko,
Oikawa Tadashi,
Nagasaka Takaharu,
Hiramitsu Takahisa,
Simabukuro Syuichi,
Suzuki Keisuke,
Sato Tetsuhiko,
Yoshihiko Watarai,
Uchida Kazuharu,
Morozumi Kunio
Publication year - 2009
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/j.1399-0012.2009.01005.x
Subject(s) - medicine , transplantation , acute tubular necrosis , kidney transplantation , kidney , adenovirus infection , lupus nephritis , gastroenterology , urology , surgery , immunology , disease , virus
We report clinical and histopathologic findings of a case of acute rejection with adenovirus infection after kidney transplantation. A 63‐yr‐old woman with end‐stage renal disease caused by lupus nephritis received an ABO‐incompatible living kidney transplantation from her husband. On the 7th post‐operative day (POD), she had fever, hematuria, and bladder irritation. Although she was treated with an antibiotic, the symptoms were not improved. We diagnosed adenovirus infection as positive with the urine shell vial method and blood PCR analysis. Cyclophosphamide was interrupted and immunoglobulin therapy was performed. However, urine output decreased and serum creatinine levels increased. An episode biopsy was performed on POD 20. We diagnosed acute antibody‐mediated rejection. She was treated with plasma exchange for acute rejection and antiviral drug (rivabirin) for active adenovirus infection. However, the renal graft dysfunction was deemed irreversible and the renal graft was removed on POD 34. The graftectomy specimen showed acute rejection and acute tubular necrosis with adenovirus infection.