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Mycotic Pseudoaneurysm After Kidney Transplantation: Two Case Reports
A Ministro1, T Ferreira2, L Batista3
1Kidney Transplant Unit, Hospital de Santa Maria, North Lisbon Hospital Center, Lisbon Academic Medical Center, Lisbon, Portugal; Vascular Surgery Department, Hospital de Santa Maria, North Lisbon Hospital Center, Lisbon Academic Medical Center, Lisbon, Portugal.
Early diagnosis and treatment of extrarenal mycotic pseudoaneurysms are crucial after kidney transplantation. Prompt surgical intervention and antifungal therapy can preserve kidney allografts, as demonstrated in two case studies.
Area of Science:
- Nephrology
- Vascular Surgery
- Infectious Diseases
Background:
- Vascular complications following kidney transplantation pose a risk to allograft survival.
- Extrarenal mycotic pseudoaneurysms are rare but serious complications.
- This report details two cases of post-transplant mycotic pseudoaneurysms.
Observation:
- Two kidney transplant recipients developed extrarenal pseudoaneurysms at 60 days and 5 months post-transplant.
- Diagnosis involved Doppler ultrasonography and CT angiography.
- Cultures identified Candida albicans as the causative agent in both patients.
Findings:
- Patient 1 underwent surgical excision, vascular reconstruction, and antifungal treatment for an iliac artery pseudoaneurysm.
- Patient 2 received thrombectomy and bypass surgery with antifungal therapy for a renal artery pseudoaneurysm.
- Both patients achieved satisfactory outcomes with preserved kidney allografts.
Implications:
- A high index of suspicion is necessary for early diagnosis of these pseudoaneurysms.
- Combined surgical and antifungal management can lead to successful kidney allograft preservation.
- This approach offers a viable strategy for managing post-transplant mycotic pseudoaneurysms.
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