EXPERIMENT ON THE DIAGNOSIS OF THE REJECTION IN THE TRANSPLANTED KIDNEY

Histochemical and Biochemical Studies

Abstract

Thirty healthy mongrel dogs were used for this study. After bilateral nephrectomy, renal transplantations were done by anastomosing the renal vessels to the common iliac vessels and ureterocutaneostomy was performed simultaneously.
Materials for the histological and histochemical studies were obtained by the open wedge biopsies 4, 7, 10, 12 and 14 days after transplantation, while control specimens were taken before the operations. The methods of histological and histochemical approach were as follows; hematoxylin-eosin stain, periodic acid-Schiff reaction, fatty stain and reactions for leucine aminopeptidase, alkaline and acid phosphatases, succinic dehydrogenase, lactic dehydrogenase, glucose-6-phosphate dehydrogenase. The level of leucine aminopeptidase (LAP) and alkaline phosphatase (AP) activities were determined in daily urine and serum, and kidney biopsy specimens were also used for the determination of the tissue content of these enzymes.
Histological and histochemical findings of the untreated autograft group were not remarkable. However, atrophy of the tubules with dilated lumen and the deterioration of the enzymatic activity in the tubules were noted in some areas of the treated autograft from 7 to 14 days after transplantations. These changes might indicate one effect of azathioprine. In the untreated homograft group, histological findings were characterized not only by lymphocytic infiltration in the peritubular, perivascular and periglomerular region, but also by the reduction of the enzymatic activities. Moreover, both LAP and AP in some of the nephrons were strongly affected from the early stage. In the treated homograft group, no marked infiltrations of the lymphocyte were observed. Nevertheless, LAP and AP demonstrated a marked reduction or complete absence, which was followed by the rejection crisis.
Biochemical estimation in the kidney tissue also showed low values of LAP and AP during the rejection reaction. The mirror image was noted on the level of LAP activity in urine and kidney specimen, while such a relationship was absent on the level of AP activity.
Therefore, it may be suggested that the reduction of LAP activity during the rejection crisis i s due to the shift of LAP to urine by an alteration of tubular permeability as a result of the immunological attack.