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U0 7 - 1845. #844043110 54 y.o. male Deceased donor renal transplant April 18/06 (APCKD) Creat 120  170  515 Being treated for CMV Rejection?. 54 yrs old male Status post deceased donor renal transplant (April 2006) baseline SCr 100-120 He had ESRD secondary to APCKD.

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U0 7 1845
U07-1845

#844043110

  • 54 y.o. male

  • Deceased donor renal transplant April 18/06 (APCKD)

  • Creat 120  170  515

  • Being treated for CMV

  • Rejection?


  • 54 yrs old male

  • Status post deceased donor renal transplant (April 2006) baseline SCr 100-120

  • He had ESRD secondary to APCKD.

  • CMV D /R, EBV D/ R, Mismatch HLA antigens

  • Medications:

    • Cellcept,Tacrolimus, prednisone

  • Past history:

    • Legally blind (retinitis pigmentosa),

    • HTN

    • Dyslipidemia




IF

  • IgG-Negative.

  • IgA-Negative.

  • IgM- Mild to moderate mesangial staining. Moderate vascular staining.

  • C3- Moderate vascular staining including peritubular capillaries.

  • C1q-Negative.

  • Kappa-Negative.

  • Lambda- Mild vascular staining.

  • Fibrinogen- Moderate interstitial staining. Moderate staining of thrombi in peritubular capillaries and glomerular capillaries.

  • Albumin-Negative.









IF

  • C4d: Moderate linear peritubular capillary staining. Mild to moderate endothelial staining in small arteries.





EM

  • Is pending


Diagnosis renal biopsy
DiagnosisRenal Biopsy:

  • Probable antibody-mediated rejection with thrombotic microangiopathy manifested

    • in glomeruli with extensive glomerular capillary thrombosis

    • and congestion and thrombosis in peritubular capillaries.

  • No evidence of T-cell mediated rejection.

  • Banff scores:

    • G0 CG0 I0 CI0 T0 CT0 V0 CV1 AH0 MM0 PTC0


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