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[Aortic valve replacement in a kidney transplant recipient]
G Matsumiya1, S Nakano, R Shirakura
1First Department of Surgery, Osaka University Medical School, Japan.
[Zasshi] [Journal]. Nihon Kyobu Geka Gakkai
|June 1, 1994
Summary
A kidney transplant recipient developed aortic valve regurgitation and underwent valve replacement. Post-surgery, a temporary rise in serum creatinine was managed with steroid pulse therapy, preserving graft function.
Area of Science:
- Nephrology
- Cardiology
- Immunology
Background:
- A 62-year-old male patient with chronic renal failure received a kidney transplant in 1989.
- The patient maintained stable graft function on immunosuppressive therapy including Cyclosporine A (CyA), Predonine (PRD), and Mizoribine.
Observation:
- The patient developed exertional dyspnea in 1990, leading to a diagnosis of aortic valve regurgitation.
- Aortic valve replacement surgery was performed in September 1991, with perioperative immunosuppression involving continuous CyA infusion and methylprednisolone.
- On postoperative day 3, serum creatinine levels elevated, despite no significant changes in peripheral blood lymphocyte subpopulations.
Findings:
- Acute rejection was suspected due to elevated creatinine, prompting steroid pulse therapy.
- Serum creatinine levels normalized within days following steroid pulse therapy.
- The patient experienced an uneventful postoperative recovery and was discharged on postoperative day 30.
Implications:
- This case highlights the successful management of a kidney transplant recipient undergoing cardiac surgery.
- Prompt intervention with steroid pulse therapy can effectively address transient renal function decline post-cardiac surgery in transplant patients.
- Maintaining immunosuppressive protocols is crucial for long-term graft survival during and after major surgical procedures in transplant recipients.