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Robot-Assisted Kidney Transplantation
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Graft Nephrectomy as Rescue Therapy for Posttransplant Rhizopus Pyelonephritis in a Pediatric Patient
Xavier L Baldwin1, Pablo Serrano Rodriguez, Volker Nickeleit
1From the Department of Surgery, University of North Carolina, Chapel Hill, North Carolina, USA.
Summary
Rhizopus infection in a pediatric kidney transplant recipient was successfully treated with surgery and antifungal therapy. Early diagnosis and intervention are crucial for managing this life-threatening complication in transplant patients.
Area of Science:
- Nephrology
- Transplant Surgery
- Mycology
Background:
- Rhizopus infection poses a significant mortality risk for transplant recipients.
- Pediatric end-stage renal disease necessitates renal transplantation for survival.
Observation:
- A 3-year-old pediatric patient with congenital hypoplastic kidneys received a deceased donor renal transplant.
- Post-transplant, the patient developed fever, acute kidney injury, and hydronephrosis, leading to a renal biopsy.
- The biopsy revealed Rhizopus infection in the transplanted kidney.
Findings:
- The patient underwent successful transplant nephrectomy with surgical debridement.
- Long-term antifungal therapy was administered for complete eradication of the Rhizopus infection.
- The patient showed no signs of residual or recurrent disease post-treatment.
Implications:
- This case underscores the critical need for prompt diagnosis and aggressive management of Rhizopus infections in pediatric renal transplant recipients.
- Successful treatment can lead to patient recovery and potential re-listing for transplantation.
- Highlighting multidisciplinary approaches in managing rare but severe post-transplant complications.
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