HISTURIA DURING RENAL TRANSPLANTATION

A large number of urine specimens from human transplanted kidneys contain an abnormal outflow of macromolecules bearing the antigenic features of kidney tissue (“histuri”). This fact has been established by analyzing 142 urine specimens from 29 allotransplanted patients and one isotransplanted patient. A standardized immunoprecipitation technique was used, with antisera precipitating only tissue components and not reacting with plasma or erythrocyte constituents. Abnormal histuria was found in 48% of all specimens (P<0.001) and decreased progressively with time following transplantation: 0-2 months, 64%; 2-6 months, 50%; 6-18 months, 36%; greater than 18 months, 0%. No correlation exists with classical proteinuria, fever, pyuria, impaired renal function, or drugs. Abnormal histuria was very common during the course of acute rejection crises, especially during the first 7 days (88%). Histuria was also noted during the first days following an isotransplantation and, in this case, is supposed to be caused by ischemia. Abnormal histuria was frequent during jaundice which sometimes occurs during the course of kidney transplantation, and here a concomitant histemia was occasionally observed. Excluding postoperative ischemia, acute rejection crisis, or jaundice, an unexplained histuria often precedes late chronic lesions of the transplant. Histuria has a significant correlation with pathological lesions of the kidney consisting of interstitial edema, cellular proliferation, and tubular alterations. Transplantation histuria may be interpreted as a leakage of organic proteins directly from altered renal cells. This phenomenon may help to forecast and prevent late rejection lesions of the transplant. © 1969 by The Williams and Wilkins Co.