Description of the Nephrology Training Program University of Alabama at Birmingham School of Medicine

JO. Rice, J.J. Curtis, M. Botero-Velez, The University of A case of selective kidney allograft rejection with Alabama at Birmingham, Department of Medicine, stable pancreas function in a patient who received Division of Nephrology, Birmingham, AL simultaneous kidney-pancreas allograft from the D.A. Laskow, The University of Alabama at Birmingham, same donor is reported. Pancreas function was Department of Surgery, Division of Transplantation, Birshown to be normal within the first month posttransmingham, AL plant by both a glucose tolerance test (despite a (J. Am. Soc. Nephrol. 1994; 4: 1841-1846) high corticosteroid dose) and stable urinary amylase ________________________________________ values during biopsy-proven acute renal allograft rejection. This patient subsequently rejected his kidney allogratt as documented by histopathologic eviReceIved November 23. 1992. Accepted November 16. 1993 dence of severe chronic vascular rejection and 2Correspondence to Dr. J.C. Rice, Division of Nephrology, The University of . . . Texas at Galveston, Galveston, TX 77555-0562. acute tubulounterstitial rejection, yet his pancreas 1046’6673/041 1-1841$03.00/0 function remained intact. He subsequently received Journal of the American Society of Nephrology . . . Copyright © 1994 by the American Society of Nephrology a six-antigen-matched kidney, continues to have Journal of the American Society of Nephrology 1841 Kidney Rejection in Kidney-Pancreas Transplant 1842 Volume 4’ Number 11’ 1994 normal fasting glucose and normal glucose toleronce by oral glucose tolerance test, and is without evidence of glucosuria. He has never had a clinical rejection of his pancreas, as evidenced by either a decline in urinary amylase or hyperglycemia, and has not required insulin except in the perioperative period of his second kidney transplant, at which time he was receiving high doses of both corficosteroids and cyclosporin. It is suggested that preferential rejection and subsequent loss of the kidney, although infrequent, do occur in combined renal-pancreas allografts and that maintenance of immunosuppression is justified until retransplanf of kidney is available.