Figure 1713

Histologic slide of a patient who received an isolated renal allograft for primary hyperoxaluria type I in which oxylate crystals are seen clearly within the tubules and interstitium. The major hazards for the renal graft after transplantation include early acute nephrocal-cinosis caused by rapid mobilization of the systemic oxalate deposits. Acute tubular obstruction by calcium oxalate crystals also can occur. Late nephrocalcinosis leads to progressive loss of renal function over several years. Rejection episodes are less common in patients receiving combined liver and kidney grafts than in those receiving kidney transplantation alone [3,19]. Acute rejection with renal dysfunction, however, causes additional episodes of acute calcium oxalate deposition in the kidney. Recurrent oxalosis can be seen as early as 3 months after transplantation.

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