Renal paratransplant hernia: a surgical complication of kidney transplantation

Renal paratransplant hernia is an uncommon and potentially fatal complication of renal transplantation. In this condition, bowel herniates through a defect in the peritoneum over the transplanted kidney and becomes trapped.

Six cases have been reported previously, and we herein report three cases encountered in 668 kidney recipients. Abdominal pain and distention with or without vomiting were the main symptoms, presenting within 4 days after surgery. Abdominal CT scan confirmed the presence of bowel obstruction and paratransplant hernia. All three patients underwent emergent laparotomy, and resection of necrotic bowel was required in one patient who died of multiple organ failure 1 week after laparotomy.

Renal paratransplant hernia is uncommon and potentially fatal, thus, prompt diagnosis and early surgical intervention are critical. Additionally, meticulous surgical technique during transplantation may help avoid this complication.