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Reversible renal allograft dysfunction and proteinuria from nutcracker-like syndrome: a case report
S G S Krishnan1, J Pritsiolas, M Susin
1Division of Kidney Diseases/Hypertension, North Shore University Hospital, 100 Community Drive, Great Neck, NY 11021, USA.
Transplantation Proceedings
|June 21, 2007
Summary
Recurrent lymphocele caused nutcracker-like syndrome, leading to kidney transplant dysfunction. Surgical drainage resolved the allograft dysfunction and proteinuria.
Area of Science:
- Nephrology
- Transplant Surgery
- Vascular Surgery
Background:
- A 27-year-old male with hypertension and renal failure underwent a living donor kidney transplant.
- He initially showed good graft function with serum creatinine at 1.7 mg/dL and a urine protein creatinine ratio of 0.1 g/g.
Observation:
- The patient experienced recurrent allograft dysfunction with elevated creatinine and proteinuria.
- These episodes were associated with a lymphocele causing renal vein compression, identified via Doppler studies.
Findings:
- The allograft dysfunction and proteinuria were attributed to a recurrent lymphocele.
- This lymphocele created a nutcracker-like syndrome, compressing the renal vein.
Implications:
- Prompt diagnosis and management of lymphocele are crucial for maintaining kidney transplant function.
- Surgical intervention, such as fluid aspiration and drainage, can effectively resolve lymphocele-induced allograft dysfunction.
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