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A CONSZDERATION OF THE CAUSE OF FUNCTIONAL ARREST OF HOMOTRANSPLANTED KIDNEYS
Author(s) -
Dempster W. J.
Publication year - 1955
Publication title -
british journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 0007-1331
DOI - 10.1111/j.1464-410x.1955.tb03445.x
Subject(s) - kidney , anuria , renal function , renal artery , medicine , chemistry , endocrinology
SUMMARY1 Observations have been made on a series of homotransplanted kidneys removed, while still functioning, on the fourth day following transfer. 2 Observations have been made on a series of second kidneys homotransplanted from the same donor to the same recipient as received the first kidney. The results indicate that if the first kidney has sufficiently sensitised the host, the second kidney will rapidly disintegrate. Otherwise second kidneys can secrete for as lopg as many first kidneys which have been left in the host until anuria occurred. 3 The rate of plasma‐cell development has been compared in the above two series, with the following results:— 4 In a series of ten kidneys four second kidneys showed an increased rate of development of plasma cells, three second kidneys showed the reverse rate of development of plasma cells, and three second kidneys showed little or no increased rate of development of plasma cells. 5 The significance of the plasma cell in homotransplanted kidneys still remains somewhat obscure. Most of the evidence, however, points to its being a genuine reaction of the kidney against the foreign serum circulating through it. 6 Certain physical changes overtake the homotransplanted kidney soon after transfer:—(a). The kidney increases in weight. ( b ) The kidney increases in size. ( c ) The branches of the renal artery within the kidney become stretched and lose their sinuous appearance.7 Some possible causes of the arrest of function of the homotransplanted kidney have been discussed.Certain of these possible causes have hwn ruled out— ( a ) Increased size. ( b ) Vascular stretch. ( c ) Increased intrarenal pressure. Other possible causes remain equivocal‐ – ( a ) Non‐pulsatile blood flow continued for several hours. ( b ) The tubule cells of the kidney themselves may produce antibody against foreign protein entering them. The result of this antigen‐antibody reaction may initiate a metabolic upset and anuria caused by an inducei renal vascular spasm. ( c ) Oxygen lack upsetting the metabolic activity of the tubule cell. 7. The fate of a kidney transplanted back to its original donor after twenty‐four or forty‐eight hours in a foreign host has been demonstrated. After twenty‐four hours in a foreign host a retransplanted kidney will continue to secrete indefinitely. After forty‐eight hours in a foreign host, a retransplanted kidney will continue to secrete for some days and then suddenly becomes anuric.