Fatal Papillary Necrosis in a Kidney Graft

RENAL papillary necrosis has been reported as complicating pyelonephritis and diabetes, 1 ureteral obstruction, 2 and other ischemic processes. 3-5 Although it has been associated with kidney transplant, 6,7 it has not, to the best of our knowledge, caused primary acute failure of a kidney graft. We describe such a case. Report of a Case A 14-year-old girl with terminal renal failure owing to medullary cystic disease was admitted to our hospital for long-term hemodialysis in 1967. Fasting and postprandial blood glucose levels were repeatedly within normal range. A year later, in January 1968, a cadaveric kidney transplantation was performed. The warm and cold ischemic times were 55 and 140 minutes respectively. The graft failed to function, although the donor's other kidney had been successfully transplanted to another recipient, and long-term satisfactory renal function has been achieved. Angiograms made 18 days after the transplantation showed patent arterial anastomosis of the