Renal allograft salvage after prolonged early posttransplant renal artery occlusion

We report a case of postoperative prolonged intrarenal segmental thrombosis in a transplanted kidney. Re-exploration, and immediate intrarenal arterial and continuous systemic heparinization after 5 1/2 hours of absent arterial flow resulted in a prolonged period of acute tubular necrosis, followed by return of nearly normal renal function 110 days after operation. The solitary denervated kidney seems to have the ability to recover from an excessively prolonged ischemic injury. The timely administration of drugs, such as methylprednisolone, mannitol and furosemide, in sufficient dosages may ameliorate ischemic damage. In our case early re-exploration with local and systemic heparinization salvaged the kidney.