Prolonged Delayed Renal Graft Function Secondary to Venous Hypertension
| Autor: | Suraj Mishra, BA, Gaurav Gupta, MD, I. Moinuddin, MD, Brian Strife, MD, Uma Prasad, MD, D. Massey, MD, PhD, Anne King, MD, Dhiren Kumar, MD, Chandra S. Bhati, MD |
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| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: | |
| Zdroj: | Transplantation Direct, Vol 3, Iss 10, p e214 (2017) |
| Druh dokumentu: | article |
| ISSN: | 2373-8731 00000000 |
| DOI: | 10.1097/TXD.0000000000000726 |
| Popis: | Abstract. The case of a 39-year-old highly sensitized woman who underwent second renal transplantation after being on warfarin because of a history of frequent thromboses of her left femoral arteriovenous graft (AVG) is reported here. The patient received a flow cytometric positive crossmatch kidney transplant from a deceased donor. Her posttransplant course was complicated by prolonged delayed graft function (DGF) lasting for 9 months. Antibody-mediated rejection occurred in the immediate postoperative period. This resolved after treatment, and resolution was confirmed by repeat biopsy. Despite this, she had persistent DGF and remained dialysis dependent. A computed tomography scan due to the development of perinephric hematoma after posttransplant biopsy demonstrated venous collateralization around the allograft. At 7 months posttransplant, a venogram during declotting of AVG revealed chronic thrombus in the inferior vena cava (IVC) above the level of native renal veins with a venous gradient of 26 mmHg. After declotting of the graft, iliac venoplasty, and subsequent IVC stent, her renal function continues to improve with a most recent creatinine of 1.4 mg/dL at 36 months posttransplant. Venous hypertension secondary to IVC thrombosis in presence of patent femoral AVG should be considered as a rare cause of prolonged DGF. |
| Databáze: | Directory of Open Access Journals |
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