Intraoperative Iliac Artery Dissection and Postoperative Cerebral Infarction in a Kidney Transplant Recipient With an...

Area of Science:

• Nephrology
• Vascular Surgery
• Genetics

Background:

• The RNF213 p.R4810K variant is linked to moyamoya disease and systemic vascular issues.
• Its role in solid organ transplantation is not well-established.

Purpose of the Study:

• To report a rare case of kidney transplantation complicated by vascular events in a patient with the RNF213 mutation.
• To emphasize the implications of RNF213 mutations in transplant recipients.

Main Methods:

• Case report of a 61-year-old man with end-stage renal disease undergoing kidney transplantation.
• Detailed description of intraoperative complications (iliac artery dissection) and postoperative events (cerebral infarction, urinary leakage).
• Genetic testing confirmed a heterozygous RNF213 p.R4810K mutation.

Main Results:

• The patient developed iliac artery dissection during surgery, requiring vascular reconstruction.
• Postoperatively, the patient experienced urinary leakage and a cerebral infarction.
• Genetic analysis revealed a heterozygous RNF213 p.R4810K mutation.

Conclusions:

• This case highlights the systemic vascular fragility associated with RNF213 mutations.
• It underscores the need for thorough preoperative evaluation, including family history, in transplant candidates.
• Tailored surgical approaches are crucial for managing high-risk patients with RNF213 variants.