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Early acute rejection with oligo-anuria was observed in 9 cases among 103 cadaver kidney allografts transplanted between January 1969 and May 1977. According to our experience this type of rejection crisis occurs between the 6th and 9th day after transplantation. It is characterized by a typical clinical course. The beginning is acute with high fever and swelling of the graft, followed by oligo-anuria demanding treatment with hemodialysis. In all cases except one there was total restoration of graft function after an oligo-anuric period of 4--16 days. The late prognosis was good in 5 cases. The other 4 patients lost their grafts during the first 4 months after transplantation as a consequence of a second irreversible rejection reaction. The pathogenesis of this early acute and reversible failure of the transplant is discussed, together with the histologic findings in one case.
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