Calvin C. Sampson

Spontaneous Renal Allograft Rupture without Rejection: A Case Report

A case of spontaneous renal allograft rupture is described. Typically, this infrequent transplant complication occurred in the early post-transplant period in an oliguric setting with progressive pain, tenderness and swelling at the transplant site associated with hypotension and a decreasing hematocrit. Prompt surgical exploration and repair of the defect in the convex border of the renal allograft controlled hemorrhage and resulted in graft survival, and a normal blood urea nitrogen and creatinine 10 months after transplantation. There have been no rejection episodes and the renal biopsy demonstrated no evidence of rejection or acute tubular necrosis. Ice preservation for 24 hours and changes secondary thereto may have made the kidney susceptible to rupture when the position of acute flexion was assumed.

Spontaneous Renal Allograft Rupture 4 Years after Transplantation

Previously, the longest reported interval between clinical renal transplantation and spontaneous renal allograft rupture was 170 days. We here report a case with an interval of 4 years between renal transplantation and the delayed spontaneous renal allograft rupture (DSR). The aetiology appears to be a vigorous rejection confirmed by operative and pathological findings. The patient who was a cadaver donor recipient presented with pain and tenderness at the transplant site, falling haematocrit, hypotension and azotaemia. The details of this presentation are discussed and the need for immediate transplant nephrectomy is emphasized.

Hormone Receptors, Tumor Differentiation, and Breast Cancer in Black Americans

One of 11 women will develop breast cancer during her lifetime (Cancer Facts and Figures 1986). Although the disease occurs more frequently in White than in Black women, mortality rates in the two groups are comparable (Cutler and Young 1975; White and Enterline 1980) because Blacks have a poorer survival rate from breast cancer than Whites. Not only is breast cancer in Blacks detected at a relatively more advanced stage than in Whites, but it also shows a consistently lower rate of survival when calculated by disease stages (Myers and Han-key 1980; Nemoto et al. 1980). Thus, a question arises to whether biological differences (independent of socioeconomic status) may account for the survival differential within stages between Blacks and Whites.