The prevalence of pulmonary infections has been assessed in a series of 93 patients who succumbed after renal transplantation. Pneumonia was considered to be the immediate cause of death in 15 patients; microscopic examination revealed further 10 cases, with pneumonic foci in the lungs. Consequently, the prevalence of pulmonary infections was 27%. Pneumonia was diagnosed on chest X-ray in only 48%, with "uraemic lung" as the most common confounding diagnosis. Clinical microbiology disclosed pathogenic bacteria in the sputum in 40% of the cases. It is concluded that the diagnostic yield would be enhanced by more frequent chest X-rays and presumably with more invasive methods of acquiring specimens for microbiological studies. It is also possible that the application of more stringent criteria for the use of high-dose intravenous steroids for supposed rejection will lead to less pneumonia in patients with renal transplants.
Abstract. Renal biopsies of 63 patients with acute oliguric renal failure have been studied. Interstitial cellular infiltration and oedema occurred in 76% of the patients. Follow‐up biopsies on 18 patients showed that chronic interstitial changes are frequent at least when the acute renal failure is due to a nephrotoxic agent.
ABSTRACT. The occurrence of late renal and extrarenal complications of primarily successful kidney transplantations is surveyed. All cases in which some surgical or clinical complication, a rejection or complication of the treatment of rejection had occurred were omitted. Primarily, 46 out of 177 transplantations (26%) were completely successful. After six months, the continued course was entirely uneventful in 21 of these cases, while in 25 some kind of complication occurred 6–72 months after the primarily successful course, 19 renal in 17 patients and 23 extrarenal in 16. The complications could not be correlated to histocompatibility, sex, age or basic disease. It may be concluded that a favourable course during the first six months gives good hope of an uneventful continuation, although even serious complications may occur occasionally.
In 1972-1979, 584 first renal transplantations were carried out. During the period 1972-1975, methylprednisolone was given for the first six months after the transplantation in a total dose of about 9 g, in addition to the usual dose of azathioprine (period 1). In 1976-1979 the total dose of methylprednisolone given during a corresponding period of time was about 4.5 g (period 2). Cutting down the dosage to half resulted in an improvement of the one-year patient survival by 16 per cent (from 63 to 79 per cent and the one-year graft survival by 10 percent (from 46 to 56 per cent).
ABSTRACT. During a three‐year period renal transplantation was performed in 12 patients with amyloidosis. This disease was primary (or the cause unknown) in two cases and secondary in ten. In the latter cases the primary disease was rheumatoid arthritis in six, ankylosing spondylitis in one, osteomyelitis in two and tuberculosis in one. Five of the 12 patients were alive one year after transplantation. Two years after transplantation four out of seven were alive. Graft survival was the same. At the end of the three‐year period five patients were alive. In two of these cases renal biopsy showed amyloid deposits in the transplant two and three years, respectively, after the transplantation.
