Acute Thrombosis of Renal Transplant Artery

Rouvière, Olivier; Berger, Pascal; Béziat, C.; Garnier, Jonathan; Lefrançois, N; Martín, Xavier; Lyonnet, D.

doi:10.1097/00007890-200202150-00014

Cited by 64 publications

(19 citation statements)

References 17 publications

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“…[2] Sudden reduction or cessation of urine output is usually the only mode of presentation with no other clinical signs or symptoms to suggest the diagnosis. A very high degree of suspicion is therefore required in early postoperative period to make a timely diagnosis of transplant renal artery thrombosis.…”

Section: Discussionmentioning

confidence: 99%

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Vascular complication in live related renal transplant: An experience of 1945 cases

et al. 2013

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Introduction and Objective:Among the surgical complications in renal transplantation, the vascular complications are probably most dreaded, dramatic, and likely to cause sudden loss of renal allograft. We present our experience and analysis of the outcome of such complications in a series of 1945 live related renal transplants.Materials and Methods:One thousand nine hundred and forty five consecutive live related renal transplants were evaluated retrospectively for vascular complications. Complications were recorded and analyzed for frequency, time of presentation, clinical presentation, and their management.Results:The age of patients ranged from 6 to 56 years (mean = 42). Vascular complications were found in 25 patients (1.29%). Most common among these was transplant renal artery stenosis found in 11 (0.58%), followed by transplant reznal artery thrombosis in 9 (0.46%), renal vein thrombosis in 3 (0.15%), and aneurysm formation at arterial anastmosis in 2 (0.10%) patient. The time of presentation also varied amongst complications. All cases of arterial thrombosis had sudden onset anuria with minimal or no abdominal discomfort, while venous thrombosis presented as severe oliguria associated with intense graft site pain and tenderness. Management of cases with vascular thrombosis was done by immediate surgical exploration. Two patients of renal artery stenosis were managed with angioplasty and stent placement.Conclusions:Major vascular complications are relatively uncommon after renal transplantation but still constitute an important cause of graft loss in early postoperative period. Aneurysm and vessel thrombosis usually require graft nephrectomy. Transplant renal artery stenosis is amenable to correction by endovascular techniques.

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Section: Discussionmentioning

confidence: 99%

“…A few cases of graft salvage in transplant renal artery thrombosis with endovascular catheter directed thrombolysis with or without angioplasty have been reported. [2] More commonly by the time diagnosis is confirmed, it is already too late and graft nephrectomy is the only option left.…”

Section: Discussionmentioning

confidence: 99%

Vascular complication in live related renal transplant: An experience of 1945 cases

et al. 2013

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“…However, with early diagnosis and intervention, it is possible to save the kidney [16, 20, 33, 58–60]. Even up to 15–20 hours after onset of symptoms, salvage has been reported [61, 62]. Flow in the occluded vessel can be reestablished by open surgery with urgent thrombectomy [16, 33].…”

Section: Graft Salvage Is Possiblementioning

confidence: 99%

Identification of Risk Factors for Vascular Thrombosis May Reduce Early Renal Graft Loss: A Review of Recent Literature

Keller

Jørgensen

Jespersen

2012

Journal of Transplantation

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Renal graft survival has improved over the past years, mainly owing to better immunosuppression. Vascular thrombosis, though rare, therefore accounts for up to one third of early graft loss. We assess current literature on transplantation, identify thrombosis risk factors, and discuss means of avoiding thrombotic events and saving thrombosed grafts. The incidence of arterial thrombosis was reported to 0.2–7.5% and venous thrombosis 0.1–8.2%, with the highest incidence among children and infants, and the lowest in living donor reports. The most significant risk factors for developing thrombosis were donor-age below 6 or above 60 years, or recipient-age below 5-6 years, per- or postoperative hemodynamic instability, peritoneal dialysis, diabetic nephropathy, a history of thrombosis, deceased donor, or >24 hours cold ischemia. Multiple arteries were not a risk factor, and a right kidney graft was most often reported not to be. Given the thrombosed kidney graft is diagnosed in time, salvage is possible by urgent reoperation and thrombectomy. Despite meticulous attentions to reduce thrombotic risk factors, thrombosis cannot be entirely prevented and means to an early detection of this complication is desirable in order to save the kidneys through prompt reoperation. Microdialysis may be a new tool for this.

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“…These studies reported successful reperfusion in most patients without significant therapy-associated complications. However, renal outcomes were only improved in some patients [ 26 – 31 ]. Angioplasty is the used treatment among patients with renal infarction caused by an intrinsic abnormality of renal vessels, such as dissection, angioplasty with stent placement.…”

Section: Discussionmentioning

confidence: 99%

Acute Renal Infarction Presenting with Acute Abdominal Pain Secondary to Newly Discovered Atrial Fibrillation: A Case Report and Literature Review

Eltawansy

Patel

Rao

et al. 2014

Case Reports in Emergency Medicine

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We report an 85-year-old female with known history of recurrent diverticulitis presented with abdominal pain. It was believed that the patient again needed to be treated for another diverticulitis and was started on the routine treatment. The initial CT scan of abdomen showed renal infarcts bilaterally that were confirmed by a CT with and without intravenous contrast secondary to unknown cause. An ECG found accidentally that the patient was in atrial fibrillation, which was the attributed factor to the renal infarctions. Subsequently, the patient was started on the appropriate anticoagulation and discharged.

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Acute Thrombosis of Renal Transplant Artery

Abstract: Fibrinolysis seems an efficient treatment that may save transplants after up to 24 hr of the arterial occlusion.

Cited by 64 publications

References 17 publications

Vascular complication in live related renal transplant: An experience of 1945 cases

Vascular complication in live related renal transplant: An experience of 1945 cases

Identification of Risk Factors for Vascular Thrombosis May Reduce Early Renal Graft Loss: A Review of Recent Literature

Acute Renal Infarction Presenting with Acute Abdominal Pain Secondary to Newly Discovered Atrial Fibrillation: A Case Report and Literature Review

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