Postreperfusion syndrome during living-related donor renal transplantation: a case report

Herein we report a case of postreperfusion syndrome (PRS) occurring during renal transplant. PRS, which is defined as a drop in mean arterial blood pressure by at least 30% for a minimum of 1 minute within 5 minutes of reperfusion and classically includes braydycardia and high pulmonary filling pressures, was first described in liver transplantation. Surprisingly, no case of PRS has been previously reported during renal transplantation.

A 66-year-old woman underwent a living-related renal transplant. Upon completing the vascular anastomosis, arterial and venous clamps were removed to restore kidney perfusion. Subsequently, the patient developed persistent sinus bradycardia at 30 bpm with simultaneous hypotension that lasted for approximately 2 minutes. Although saline boluses, ephedrine, atropine, and 100 microg of epinephrine were administered, the patient's hemodynamics were not restored until an additional 300 microg of epinephrine were administered.

This case confirms the hypothesis of previous authors who predicted that PRS likely occurs in non-liver transplantation.