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[Multiple complications after renal transplantation].
J Manrique1, E Rossich, A Hernández Sierra
1Servicio de Nefrología, Clínica Universitaria de Navarra, Pamplona. jmanrique@unav.es
Summary
This case study details a kidney transplant recipient who experienced numerous complications, including infections, digestive issues, and metabolic problems, over 16 years. Despite these challenges, the patient maintained acceptable renal function and quality of life.
Area of Science:
- Nephrology
- Transplant Surgery
- Immunology
Background:
- A 32-year-old male with end-stage renal disease due to focal and segmental glomerulonephritis received a cadaveric kidney transplant.
- The patient underwent four years of hemodialysis prior to transplantation.
Observation:
- The patient experienced severe acute tubular necrosis and two episodes of acute rejection in the early post-transplant period.
- Infectious complications included herpes zoster and Pseudomonas aeruginosa pneumonia.
- Digestive complications encompassed cholecystitis, pancreatic pseudocyst, upper digestive bleeding, and subphrenic abscess, necessitating multiple surgical interventions.
- Metabolic complications included carbohydrate intolerance, cataracts, and avascular bone necrosis, linked to immunosuppressive therapy.
Findings:
- The patient developed a wide spectrum of complications over 16 years post-transplant.
- Calcified chronic pancreatitis was a long-term complication.
- Immunosuppressive therapy was associated with metabolic and other complications.
Implications:
- Long-term kidney transplant recipients can face diverse and severe complications.
- Management requires addressing infectious, digestive, metabolic, and surgical issues.
- Despite complications, acceptable renal function and quality of life are achievable with ongoing care.