EVALUATION OF THE EFFICACY OF ANTI-REJECTION THERAPY USING THE QUANTITATIVE ANALYSIS OF GUANIDINOACETIC ACID (GAA) URINARY

transplants, rejection of grafts is a common complication. When it is difficult to make diagnoses using conventional biochemical parameters, histopathological studies of grafts have been under­ taken to clarify the clinical events. Even in cases of success­ ful biopsies, consecutive procedures are not possible. Therefore~ since the urinary excretion of GAA reflects the metabolic func­ tioning of the kidney, we examined the daily level of GAA in urine after transplantation and considered the feasibility of using this measure as a guide to the early detection of rejection and whether or not the amount of GAA urinary excretion could contribute to the evaluation of the efficacy as weIl as the sufficiency of anti-re­ jection therapy. Eight cases of renal transplants from living related donors and 4 cases from cadavers were included in this study. All pa­ tients receiving renal transplants from living related donors received donor specific buffy coat transfusions (DSBCT) preopera­ tively. The 4 cadaver kidneys from brain-dead donors were pre­ served for 7 to 54 hours by means of simple cold storage. However, acute tubular necrosis (ATN) was noted postoperatively in all these cases and required hemodialysis therapy for about 2 weeks. Pertinent da ta for the recipients are presented in Table 1.