Hyperacute Cortical Necrosis After Antibody Pretreatment of Syngeneic Rat Kidney Transplants

A model to study antibody-mediated, hyperacute rejection of rat kidney transplants was designed, omitting immune cells in the rejection process. Syngeneic kidney transplants were perfused with hyperimmune heterologous or isologous serum prior to transplantation. If a sufficient amount of antiserum was used for perfusion, hyperacute cortical necrosis developed after revascularization. Intra-capillary deposition of fibrin and polymorphonuclear hypercellularity in glomeruli, along with glomerular leakage of protein and erythrocytes, were dominant early features of this reaction; they were rapidly followed by occurrence of vascular thrombi and necrosis of tubule cells in the outer cortex.