U # Donor kidney biopsy

Donor 25 yrs old female Blood group: A+ Wt 90 Kg, Ht 180 cm S/P MVA 03 Jan 2007: –Subarachnoid and intracerebral hemorrhage –Fracture C1 –Retroperitoneal hemorrhage No high risk behaviors Medications: birth control pills, Effexor

BP initially low started on vasopressin and levophed (short time) then BP  high requiring iv Labetalol (180/130 mmHg) CMV negative, EBV + U/A negative 2 days later +3 Hb, RBC >50,WBC 1- 5 SCr 55 urea days later 41 and 2 respectively Hb 69 platelet 82 INR 1.2 PTT 35

Recipient 53 yrs old male He had ESRD 2nd to APCKD was on PD since Nov 2005 Past Hx: –Aortic valve replacement in 1979 and 1991, last one November 2003 (porcine), –DDD pacemaker –Atrial fibrillation - on Coumadin –hyperparathyroidism –HTN

Intra operative course complicated by hypotension requiring 5-6 doses of epinephrine Post operatively low urine out put 3-4 days (slow graft function) CMV D/R negative both EBV D/R positive both 3 weeks post transplant SCr

Diagnosis Renal Biopsy: Focal glomerular capillary thrombosis of unknown etiology Mild tubular degenerative changes No definite evidence of rejection Banff score: –G0 CG0 I0 CI0 T0 CT0 V0 CV1 AH0 MM0