TUBULAR ANTITHROMBIN AT TRANSPLANTATION DETERMINES SUBSEQUENT RENAL-ALLOGRAFT FUNCTION

Background. Antithrombin is found in the microvasculature and tubules of normal and transplanted human kidneys. Although depletion of vascul ar antithrombin is associated with renal allograft dysfunction, neithe r the distribution nor clinical significance of tubular antithrombin i s known. Methods. Changes in tubular antithrombin in biopsy specimens (n=41) obtained from donor kidneys at transplantation were studied imm unohistochemically. The relationship between these changes and subsequ ent graft function was analyzed. Results. Granular intracellular antit hrombin was found only within the proximal tubular epithelium. Allogra fts with depleted tubular antithrombin at transplantation (n=20) had s ignificantly greater plasma creatinine concentrations at posttransplan t days 3 (P<0.001) and 5 (P<0.03) than allografts with normal tubular antithrombin (n=21). Indeed, depletion of tubular antithrombin at tran splantation correlated with the degree of graft dysfunction at 3 days after transplantation. Conclusions. Depleted tubular antithrombin at t ransplantation is associated with reduced early graft function, and th is may identify patients at risk of a complicated follow-up.