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Nephrorrhagy from a transplanted kidney

E T Jacob, A A Sidi, M D Heim

    International Surgery
    |January 1, 1982
    PubMed
    Summary
    This summary is machine-generated.

    A rare veno-calyceal fistula caused unexplained bleeding after a kidney transplant. This highlights the need to carefully evaluate donor kidneys, especially after abdominal trauma, to prevent transplant complications.

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    Area of Science:

    • Nephrology
    • Transplant Surgery
    • Urology

    Background:

    • Kidney transplantation is a life-saving procedure for end-stage renal disease.
    • Donor kidney selection is critical to transplant success.
    • Blunt abdominal trauma in donors can lead to occult injuries.

    Observation:

    • A kidney from a donor with cranio-cerebral and blunt abdominal trauma was transplanted.
    • The recipient experienced significant, unexplained post-transplant bleeding (nephrorrhagy).
    • Standard diagnostic methods, including angiography and cystoscopy, failed to identify the bleeding source.

    Findings:

    • A veno-calyceal fistula was discovered upon graftectomy, explaining the persistent hemorrhage.
    • This fistula was not detectable through conventional pre-transplant assessments.

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  • Visual inspection and perfusion characteristics of the allograft were insufficient to rule out such pathology.

    • Implications:

    • Kidneys from donors with abdominal trauma require meticulous evaluation beyond standard protocols.
    • Occult vascular injuries like veno-calyceal fistulas can lead to severe post-transplant complications.
    • Discarding kidneys from donors with even localized abdominal trauma may be warranted to ensure graft viability and patient safety.