Onset of Dialysis Encephalopathy in Cyclosporine-Treated Renal Allograft Recipients

Three patients who developed typical features of dialysis encephalopathy following renal transplantation are presented. No patient had evidence of overt neurological dysfunction pretransplantation. All patients were taking cyclosporine at the time of onset of neurological disease. Two patients died as a result of their neurological condition. The third patient made a satisfactory recovery. Factors responsible for the onset of dialysis encephalopathy in the renal posttransplantation period are discussed. We propose that cyclosporine may have been an important precipitating factor of the neurological syndrome of these patients

EFFECT OF OKT3 IN STEROID-RESISTANT RENAL-TRANSPLANT REJECTION

Between January 1, 1982, and November 1, 1986, 169 cadaver renal graft transplantations were performed at this hospital with CsA as induction therapy. OKT3 was not available in this period. Of these grafts, 15.9% were lost within 6 months, 10.7% from acute rejection (AR). Between November 1, 1986, and October 1, 1992, 483 cadaver renal graft transplantation were performed. Induction therapy included CsA and OKT3 was available. Of these grafts, 8.7% were lost inside 6 months, 3.1% from AR. Of these last 483 grafts, 113 received 125 courses of OKT3. Ten courses were prophylactic, and 115 courses in 103 patients were for rejection resistant to steroid therapy (biopsy proven in all but 2 cases. Ninety-three percent of rejection episodes treated with OKT3 responded, at least initially. Graft survival in OKT3-treated patients was 81%, 77%, and 76% at 6 months, 1 year, and 2 years, respectively. In contrast, graft survival in steroid-resistant rejection during the first period (without OKT3) was 59%, 57%, and 57% at these intervals

RECOVERY OF GASTROINTESTINAL FUNCTION AFTER RENAL-TRANSPLANTATION IN A PATIENT WITH SCLEROSING PERITONITIS SECONDARY TO CONTINUOUS AMBULATORY PERITONEAL-DIALYSIS

We describe the rapid and dramatic improvement in gastrointestinal function that occurred after successful renal transplantation in a woman with severe sclerosing peritonitis secondary to continuous ambulatory peritoneal dialysis (CAPD), We postulate that the antiinflammatory effect of the immunosuppressive agents was the most important factor leading to the patient's recovery. (C) 1995 by the National Kidney Foundation, Inc