1977 Volume 68 Issue 6 Pages 599-608
The urinary and serum fibrin/fibrinogen degradation products (FDP) of 27 human renal allotransplanted patients has been measured using the techniques of TRCHII.
Urinary FDP were detected in all cases in the immediate postoperative period, but if the transplant had good function urinary FDP fell to undetectable levels in 3-10 days (mean 7.2 days). Urinary FDP were detected during rejection episodes in 26 of 31 occasions, especially in all of 20 early rejection episodes which occurred within 2 months after transplantation. In 10 of 14 cases appearances of urinary FDP preceded the clinical diagnosis of rejection episodes by periods of 1 to 5 days, and in 19 of 22 cases (86.4%) measurements were of value in early detection or prediction of rejection episodes. Disappearances of urinary FDP also tended to precede the recovery from rejection crisis. In early rejection the levels of urinary FDP has been correlated with severity of rejection and irreversibly rejected allografts excreted high levels of FDP for long periods; the measurements may be of prognostic value for the ultimate outcome. In late rejection, however, urinary FDP was not always positive even if rejection was severe and irreversible.
In one case of acute tubular necrosis positive urinary FDP continued for 12 days of the following diuretic phase. Other complications such as perirenal lymphocele, urinary tract infection and renal vein thrombosis did not cause positive urinary FDP in our study.
Serum FDP also has been measured in this series, but it may be of few values in diagnosis of rejection. Other hematologic examinations in several patients suggested that systemic changes of coagulation fibrinolysis system during rejection episodes were not significant.
