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Venous Embolus to a Transplanted Kidney: Diagnosis and Treatment

Venous Embolus to a Transplanted Kidney: Diagnosis and Treatment Abstract • We are reporting the first case, to our knowledge, of a venous embolus to a transplanted kidney. The embolus occurred five days after transplantation of a cadaver kidney in a 31-year-old woman who was receiving estrogen-progesterone therapy for menorrhagia. Five hours after the acute onset of left flank pain and anuria, the embolus was identified at the anastomosis of the donor renal vein to the external iliac vein. The embolus was manipulated distally in the external iliac vein and excluded by proximal division of the vein. Recovery was eventually complete, despite two major postoperative complications, acute tubular necrosis and a perirenal hematoma secondary to heparin sodium therapy. Radionuclide scanning was critically important in establishing the diagnosis and in assessing the potential for the kidney to recover from acute tubular necrosis. On the basis of this experience, we believe that prompt surgical intervention is indicated for acute venous occlusion. (Arch Surg 111:1135-1138, 1976) References 1. Clarke SD, Kennedy JA, Hewitt JC, et al: Successful removal of thrombus from renal vein after renal transplantation . Br Med J 1:154-156, 1970.Crossref 2. Nerstrom B, Ladefoged J, Lund F: Vascular complications in 155 consecutive kidney transplantations . Scand J Urol Nephrol 6( (suppl 15) ):65-74, 1972.Crossref 3. Khastagir B, Montandon A, Nakamoto S, et al: Early and late failures of human cadaveric renal allografts . Arch Intern Med 123:8-14, 1969.Crossref 4. Owen K: Renal transplantation . Br J Hosp Med 2:1216-1219, 1969. 5. Smellie WAB, Vinik M, Freed TA, et al: Pertrochanteric venography in the study of human renal transplant recipients . Surg Gynecol Obstet 126:777-780, 1968. 6. Starzl TE: Experience in Renal Transplantation . Philadelphia, WB Saunders Co, 1964. 7. Sorensen BL, Hald T, Nissen HM: Silent iliac compression syndrome as a cause of renal vein thrombosis after transplantation . Scand J Urol Nephrol 6( (suppl 15) ):75-77, 1972.Crossref 8. Collste LG, Bostrom H, Magnusson G, et al: Streptokinase treatment of a thrombosis at the site of the venous connection of a kidney transplant . Scand J Urol Nephrol 5:80-83, 1971.Crossref 9. Walsh A: Some practical problems in kidney transplantation . Transplant Proc 1:178-183, 1969. 10. Cockett FB, Thomas ML: The iliac compression syndrome . Br J Surg 52:816-821, 1965.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

Venous Embolus to a Transplanted Kidney: Diagnosis and Treatment

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References (10)

Publisher
American Medical Association
Copyright
Copyright © 1976 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.1976.01360280093015
Publisher site
See Article on Publisher Site

Abstract

Abstract • We are reporting the first case, to our knowledge, of a venous embolus to a transplanted kidney. The embolus occurred five days after transplantation of a cadaver kidney in a 31-year-old woman who was receiving estrogen-progesterone therapy for menorrhagia. Five hours after the acute onset of left flank pain and anuria, the embolus was identified at the anastomosis of the donor renal vein to the external iliac vein. The embolus was manipulated distally in the external iliac vein and excluded by proximal division of the vein. Recovery was eventually complete, despite two major postoperative complications, acute tubular necrosis and a perirenal hematoma secondary to heparin sodium therapy. Radionuclide scanning was critically important in establishing the diagnosis and in assessing the potential for the kidney to recover from acute tubular necrosis. On the basis of this experience, we believe that prompt surgical intervention is indicated for acute venous occlusion. (Arch Surg 111:1135-1138, 1976) References 1. Clarke SD, Kennedy JA, Hewitt JC, et al: Successful removal of thrombus from renal vein after renal transplantation . Br Med J 1:154-156, 1970.Crossref 2. Nerstrom B, Ladefoged J, Lund F: Vascular complications in 155 consecutive kidney transplantations . Scand J Urol Nephrol 6( (suppl 15) ):65-74, 1972.Crossref 3. Khastagir B, Montandon A, Nakamoto S, et al: Early and late failures of human cadaveric renal allografts . Arch Intern Med 123:8-14, 1969.Crossref 4. Owen K: Renal transplantation . Br J Hosp Med 2:1216-1219, 1969. 5. Smellie WAB, Vinik M, Freed TA, et al: Pertrochanteric venography in the study of human renal transplant recipients . Surg Gynecol Obstet 126:777-780, 1968. 6. Starzl TE: Experience in Renal Transplantation . Philadelphia, WB Saunders Co, 1964. 7. Sorensen BL, Hald T, Nissen HM: Silent iliac compression syndrome as a cause of renal vein thrombosis after transplantation . Scand J Urol Nephrol 6( (suppl 15) ):75-77, 1972.Crossref 8. Collste LG, Bostrom H, Magnusson G, et al: Streptokinase treatment of a thrombosis at the site of the venous connection of a kidney transplant . Scand J Urol Nephrol 5:80-83, 1971.Crossref 9. Walsh A: Some practical problems in kidney transplantation . Transplant Proc 1:178-183, 1969. 10. Cockett FB, Thomas ML: The iliac compression syndrome . Br J Surg 52:816-821, 1965.Crossref

Journal

Archives of Surgery – American Medical Association

Published: Oct 1, 1976

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