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Renal Allograft Rupture With Iliofemoral Thrombophlebitis

Renal Allograft Rupture With Iliofemoral Thrombophlebitis Abstract • Spontaneous rupture of a renal allograft in the early posttransplant period is associated with tachycardia, hypotension, oliguria, swelling, pain, a falling hematocrit level, and tenderness at the transplant site. Occasionally, the ruptured allograft can be saved by control of the hemorrhage. Deep vein thrombophlebitis, a common occurrence after prolonged surgery and cortocosteroid therapy, is less common in renal allograft transplantation, but may be associated with renal vein thrombosis. The simultaneous occurrence of deep vein thrombophlebitis, renal vein thrombosis, and allograft rupture contraindicates anticoagulent therapy. We present a patient in whom ipsilateral deep vein thrombophlebitis developed eight days after a cadaveric renal allograft, followed in two days by hypotension, a falling hematocrit level, oliguria, and a painfall mass at the allograft site. Surgical exploration revealed a ruptured allograft with iliofemoral and renal vein thrombosis and profuse hemorrhage. A transplant nephrectomy was performed. (Arch Surg 113:204-205, 1978) References 1. Haimov M, Glabman S, Burrows L: Spontaneous rupture of the allografted kidney . Arch Surg 103:510-512, 1971.Crossref 2. Anderson B, Sampson C, Callender CO: Spontaneous renal allograft rupture without rejection: A case report . J Urol 115:745-746, 1976. 3. Kootstra G, Meijer S, Elema JD: "Spontaneous" rupture of homografted kidneys . Arch Surg 108:107-112, 1974.Crossref 4. Lord RS, Effeney DJ, Hayes JM, et al: Renal allograft rupture: Cause, clinical features and management . Ann Surg 177:268-273, 1973.Crossref 5. Arruda JA, Gutierrez LF, Jonasson O, et al: Renal-vein thrombosis in kidney allografts . Lancet 2:585-586, 1973.Crossref 6. Nerstrom B, Ladefoged J, Lund F: Vascular complications in 155 consecutive kidney transplantations . Scand J Urol Nephrol 6( (suppl 15) ):65-74, 1972.Crossref 7. Murray JE, Wilson RE, Tilney NL, et al: Five years' experience in renal transplantations with immunosuppressive drugs: Survival, function, complications and the role of the lymphocyte depletion by thoracic duct fistula . Ann Surg 168:416-435, 1968.Crossref 8. Mandel SR, Mattern WD, Staab E: Venous embolus to a transplanted kidney: Diagnosis and treatment . Arch Surg 111:1135-1138, 1976.Crossref 9. Cosgriff SW: Thromboembolic complications associated with ACTH and cortisone therapy . JAMA 147:924-926, 1951.Crossref 10. Skillman JJ: Postoperative deep vein thrombosis and pulmonary embolism: A selective review and personal viewpoint . Surgery 75:114-122, 1974. 11. Venkateswara R, Smith EJ, Alexander JW, et al: Thromboembolic disease in renal allograft recipients . Arch Surg 111:1086-1092, 1976.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

Renal Allograft Rupture With Iliofemoral Thrombophlebitis

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Publisher
American Medical Association
Copyright
Copyright © 1978 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.1978.01370140094021
Publisher site
See Article on Publisher Site

Abstract

Abstract • Spontaneous rupture of a renal allograft in the early posttransplant period is associated with tachycardia, hypotension, oliguria, swelling, pain, a falling hematocrit level, and tenderness at the transplant site. Occasionally, the ruptured allograft can be saved by control of the hemorrhage. Deep vein thrombophlebitis, a common occurrence after prolonged surgery and cortocosteroid therapy, is less common in renal allograft transplantation, but may be associated with renal vein thrombosis. The simultaneous occurrence of deep vein thrombophlebitis, renal vein thrombosis, and allograft rupture contraindicates anticoagulent therapy. We present a patient in whom ipsilateral deep vein thrombophlebitis developed eight days after a cadaveric renal allograft, followed in two days by hypotension, a falling hematocrit level, oliguria, and a painfall mass at the allograft site. Surgical exploration revealed a ruptured allograft with iliofemoral and renal vein thrombosis and profuse hemorrhage. A transplant nephrectomy was performed. (Arch Surg 113:204-205, 1978) References 1. Haimov M, Glabman S, Burrows L: Spontaneous rupture of the allografted kidney . Arch Surg 103:510-512, 1971.Crossref 2. Anderson B, Sampson C, Callender CO: Spontaneous renal allograft rupture without rejection: A case report . J Urol 115:745-746, 1976. 3. Kootstra G, Meijer S, Elema JD: "Spontaneous" rupture of homografted kidneys . Arch Surg 108:107-112, 1974.Crossref 4. Lord RS, Effeney DJ, Hayes JM, et al: Renal allograft rupture: Cause, clinical features and management . Ann Surg 177:268-273, 1973.Crossref 5. Arruda JA, Gutierrez LF, Jonasson O, et al: Renal-vein thrombosis in kidney allografts . Lancet 2:585-586, 1973.Crossref 6. Nerstrom B, Ladefoged J, Lund F: Vascular complications in 155 consecutive kidney transplantations . Scand J Urol Nephrol 6( (suppl 15) ):65-74, 1972.Crossref 7. Murray JE, Wilson RE, Tilney NL, et al: Five years' experience in renal transplantations with immunosuppressive drugs: Survival, function, complications and the role of the lymphocyte depletion by thoracic duct fistula . Ann Surg 168:416-435, 1968.Crossref 8. Mandel SR, Mattern WD, Staab E: Venous embolus to a transplanted kidney: Diagnosis and treatment . Arch Surg 111:1135-1138, 1976.Crossref 9. Cosgriff SW: Thromboembolic complications associated with ACTH and cortisone therapy . JAMA 147:924-926, 1951.Crossref 10. Skillman JJ: Postoperative deep vein thrombosis and pulmonary embolism: A selective review and personal viewpoint . Surgery 75:114-122, 1974. 11. Venkateswara R, Smith EJ, Alexander JW, et al: Thromboembolic disease in renal allograft recipients . Arch Surg 111:1086-1092, 1976.Crossref

Journal

Archives of SurgeryAmerican Medical Association

Published: Feb 1, 1978

References