The treatment of deep vein thrombosis immediately after kidney transplantation: a case report

Ipsilateral acute iliofemoral deep vein thrombosis (DVT) immediately after kidney transplantation is rare but highly morbid, resulting in allograft failure, rupture, or even death. Treatment modalities for iliofemoral DVT occurring just after transplantation are limited due to bleeding risk and impaired renal function. A 55-year-old woman with end-stage renal disease from hypertension underwent a living nonrelated donor procedure using a kidney from her husband. On postoperative day 1, the patient presented edema and pain in the right lower extremity associated with local heat and redness. The symptoms became aggravated with time. Duplex ultrasonography (US) revealed a DVT involving from the right femoral vein to the common iliac vein and an increased resistive index of 0.96 to 0.97. A venogram using carbon dioxide as the contrast medium showed also same findings as the duplex US. After inferior vena cava filter insertion, percutaneous transluminal thromboaspiration (PTA) was performed with complete removal of the thrombus. Early PTA with carbon dioxide as intravenous contrast material seemed to be an effective and safe procedure to treat this complication.