Late spontaneous decapsulation of the kidney graft in a patient with hepatitis C and treated with sirolimus: possible pathophysiological association in a rare complication

Leal, Rita; Pinto, Helena; Alves, Rui; Figueiredo, Arnaldo

doi:10.1136/bcr-2016-218335

Cited by 3 publications

(1 citation statement)

References 10 publications

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“…It was possible that sirolimus precipitated the spontaneous decapsulation as lymphocele formation is one of the known side effects. Leal et al [9] reported the successful treatment of a case of late spontaneous decapsulation by converting the patient from sirolimus to cyclosporine and performing marsupialization.…”

Section: Discussionmentioning

confidence: 99%

A Rare Case of Decapsulation Injury in a Transplant Kidney: A Case Study and Review of the Literature

Paranjpe¹,

Alkokar²,

Sultan³

et al. 2017

Arch Clin Med Case Rep

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Postoperative perinephric collections are known complications of a transplant kidney with decapsulation injury being one of its rare etiologies. It can be early onset due to capsular injury during laparoscopic donor nephrectomy or late onset usually due to immunosuppressive medications or spontaneous in nature. We report a rare case of late onset decapsulation injury following insertion of a percutaneous nephrostomy drain for treating hydronephrosis. It was subsequently treated with marsupialization of the collection and creating a peritoneal window. Complete resolution of the perinephric collections was noted on follow up. On review literature, it was found that there is no unanimous management protocol related to decapsulation injuries. We have made an attempt to concise various treatment approaches mentioned in the literature for such cases and their outcomes. In case of patients with late onset decapsulation injuries such as ours, marsupialization has shown success in majority of cases obviating the need for nephrectomy. We suggest that marsupialization can form a reliable first line treatment following late onset decapsulation without any clear etiology, in majority of cases.

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Section: Discussionmentioning

confidence: 99%