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A kidney transplant patient experienced graft pain due to multifocal renal cortical infarction, likely from emboli. Treatment with acetylsalicylic acid (aspirin) improved renal function, and follow-up imaging showed defect resolution.

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Area of Science:

  • Nephrology
  • Radiology
  • Transplant Surgery

Background:

  • Renal allograft dysfunction can occur post-transplantation.
  • Early diagnosis of complications like infarction is crucial for graft survival.

Purpose of the Study:

  • To report a case of multifocal renal cortical infarction in a post-renal transplant patient.
  • To evaluate the diagnostic utility of advanced imaging techniques in this condition.

Main Methods:

  • Contrast-enhanced CT scan to assess renal graft perfusion.
  • [99mTc]Tc-DMSA SPECT/CT for functional assessment of renal uptake.
  • [18F]PSMA-1007 PET/CT for detailed defect localization.

Main Results:

  • CT revealed multiple small perfusion defects in the renal graft cortex.
  • SPECT/CT and PET/CT confirmed and further characterized these defects, indicative of multifocal renal cortical infarction.
  • Infarction was presumed to originate from intraoperative emboli at the arterial anastomosis.

Conclusions:

  • Multifocal renal cortical infarction is a potential complication after renal transplantation.
  • Advanced imaging modalities like SPECT/CT and PET/CT are valuable in diagnosing and characterizing renal cortical infarction.
  • Acetylsalicylic acid treatment demonstrated a favorable outcome in this case, suggesting its potential role in managing such complications.