Hallazgos de autopsia en 66 transplantados renales

the first renal transplant was carried out in the hospital méxico in 1973. until december of 2000, 507 allografts had been completed, so that this hospital has become the main transplantation center in central america. in this period 105 patients have died (20,7%), 66 of which have been subjected to postmortem study. the objectives of this study were to analyze the survival, the main pathological findings and the causes of death in this population. the clinical histories, the autopsy protocols and the histopathological lesions of the renal transplantation patients that have died and that have been autopsied between 1973 and december 31 the 2000 were reviewed. the patients survived for periods ranging from less than 1 month (11cases) to more than 1 year (33 cases), with an average of 33.4 months. the main causes of death were: 1. bacterial and opportunistic infections: 25 cases (37.8%); 2. reject of the implant: 17 cases (25%); 3.cardiovascular complications: 11 cases (16.6%); 4. hemodynamic dysfunction: 6 cases (9%). the infections constitute a permanent hazard for all inmunosupressed patients. however, since the introduction cyclosporin (1987), their incidence and severity has diminished notably. the chronic disfunction of the transplant (chronic vascular rejection; chronic transplant glomerulopathy, etc.) has become another serious problem in the long term management of this polulation. indeed, only 4 of the last 31 patients who died maintained adequate renal function at the moment of death.