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Cambou L, Millet C, Terrier N, Malvezzi P, Timsit MO, Anglicheau D, Badet L, Morelon E, Prudhomme T, Kamar N, Lejay A, Perrin P, Uro-Coste C, Pereira B, Heng AE, Garrouste C, Guy L. Management and Outcome After Early Renal Transplant Vein Thrombosis: A French Multicentre Observational Study of Real-Life Practice Over 24 Years. Transpl Int 2023; 36:10556. [PMID: 37035106 PMCID: PMC10077970 DOI: 10.3389/ti.2023.10556] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 03/10/2023] [Indexed: 04/11/2023]
Abstract
Early (<14 days) renal transplant vein thrombosis posttransplant (eRVTPT) is a rare but threatening complication. We aimed to assess eRVTPT management and the rate of functional renal transplantation. Of 11,172 adult patients who had undergone transplantation between 01/1997 and 12/2020 at 6 French centres, we identified 176 patients with eRVTPT (1.6%): 16 intraoperative (Group 1, G1) and 160 postoperative (Group 2, G2). All but one patient received surgical management. Patients in group G2 had at least one imaging test for diagnostic confirmation (N = 157, 98%). During the operative management of the G2 group, transplantectomy for graft necrosis was performed immediately in 59.1% of cases. In both groups, either of two techniques was preferred, namely, thrombectomy by renal venotomy or thrombectomy + venous anastomosis repair, with no difference in the functional graft rate (FGR) at hospital discharge (p = NS). The FGR was 62.5% in G1 and 8.1% in G2 (p < 0.001). Numerous complications occurred during the initial hospitalization: 38 patients had a postoperative infection (21.6%), 5 experienced haemorrhagic shock (2.8%), 29 exhibited a haematoma (16.5%), and 97 (55.1%) received a blood transfusion. Five patients died (2.8%). Our study confirms the very poor prognosis of early renal graft venous thrombosis.
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Affiliation(s)
- Ludivine Cambou
- Clermont-Ferrand University Hospital, Department of Urology, Clermont-Ferrand, France
| | - Clémentine Millet
- Clermont-Ferrand University Hospital, Department of Urology, Clermont-Ferrand, France
| | | | - Paolo Malvezzi
- Service de Néphrologie, Hémodialyse, Aphérèses et Transplantation Rénale, CHU Grenoble-Alpes, Grenoble, France
| | - Marc-Olivier Timsit
- Necker Hospital, Assistance Publique-Hôpitaux de Paris, Department of Urology, Paris, France
| | - Dany Anglicheau
- Necker Hospital, Assistance Publique-Hôpitaux de Paris, Department of Nephrology and Kidney Transplantation, Paris, France
| | - Lionel Badet
- Service d’Urologie, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France
| | - Emmanuel Morelon
- Service de Néphrologie, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France
| | - Thomas Prudhomme
- Toulouse University Hospital, Department of Urology, Toulouse, France
| | - Nassim Kamar
- Service de Néphrologie, Hémodialyse, Aphérèses et Transplantation Rénale, CHU Grenoble-Alpes, Grenoble, France
- Toulouse University Hospital, Department of Nephrology, Toulouse, France
| | - Anne Lejay
- Department of Vascular Surgery and Kidney Transplantation, University of Strasbourg, Strasbourg, France
| | - Peggy Perrin
- Department of Nephrology and Transplantation, University Hospital, Strasbourg, France
- Fédération de Médecine Translationnelle (FMTS), Strasbourg, France
- INSERM U1109, LabEx TRANSPLANTEX, Strasbourg, France
| | - Charlotte Uro-Coste
- Clermont-Ferrand University Hospital, Department of Nephrology, 3iHP, Clermont-Ferrand, France
| | - Bruno Pereira
- Clermont-Ferrand University Hospital, Biostatistics Unit (DRCI), Clermont-Ferrand, France
| | - Anne Elisabeth Heng
- Clermont-Ferrand University Hospital, Department of Nephrology, 3iHP, Clermont-Ferrand, France
| | - Cyril Garrouste
- Clermont-Ferrand University Hospital, Department of Nephrology, 3iHP, Clermont-Ferrand, France
- *Correspondence: Cyril Garrouste,
| | - Laurent Guy
- Clermont-Ferrand University Hospital, Department of Urology, Clermont-Ferrand, France
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Xu RF, He EH, Yi ZX, Li L, Lin J, Qian LX. Diagnosis and spontaneous healing of asymptomatic renal allograft extra-renal pseudo-aneurysm: A case report. World J Clin Cases 2021; 9:3943-3950. [PMID: 34141751 PMCID: PMC8180219 DOI: 10.12998/wjcc.v9.i16.3943] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 01/09/2021] [Accepted: 02/11/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Transplant renal artery stenosis is a relatively frequent vascular complication after transplantation. However, extra-renal pseudo-aneurysms (EPSAs) are rare after transplantation; they can be life-threatening and usually need open surgical repair. We discuss the diagnosis and spontaneous healing of an asymptomatic renal allograft EPSA caused by renal artery anastomotic stenosis, which was diagnosed in a timely manner and managed by conservative treatments.
CASE SUMMARY We present a 37-year-old male patient diagnosed with a renal allograft EPSA caused by renal artery anastomotic stenosis due to multiple atherosclerotic plaques with ultrasonographic examination 6 mo post transplantation. The stenosis rate of 90% and the EPSA were verified by computed tomography angiography. The diagnosis was further confirmed with digital subtraction angiography. Percutaneous transluminal angiography was conducted, and a metallic stent was successfully implanted at the stenosed site of the main renal artery trunk. No further intervention for the EPSA was undertaken due to the difficulty of stenting and the risk of bleeding; regular ultrasonographic follow-ups were recommended. The stenosis was significantly relieved immediately after stent implantation and the EPSA was healed spontaneously by completely filling with hypo-echoic thrombosis 8 mo after stenting.
CONCLUSION Ultrasonography combined with a high-frequency linear probe can detect vascular complications post renal transplantation at an early stage and improve prognosis.
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Affiliation(s)
- Rui-Fang Xu
- Department of Ultrasound, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - En-Hui He
- Department of Ultrasound, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - Zhan-Xiong Yi
- Department of Ultrasound, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - Li Li
- Department of Ultrasound, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - Jun Lin
- Department of Urology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - Lin-Xue Qian
- Department of Ultrasound, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
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3
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Franco A, González Y, Balibrea N, Díaz M, Planells MC, Pérez Contreras FJ. Posterior reversible encephalopathy syndrome. A case in a renal transplant recipient with refractory hypertension due to iliac artery stenosis. Nefrologia 2019; 39:677-679. [PMID: 31103245 DOI: 10.1016/j.nefro.2019.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Accepted: 02/21/2019] [Indexed: 10/26/2022] Open
Affiliation(s)
- Antonio Franco
- Servicios de Nefrología, Hospital General Universitario de Alicante, Alicante, España.
| | - Yussel González
- Servicios de Nefrología, Hospital General Universitario de Alicante, Alicante, España
| | - Noelia Balibrea
- Servicios de Nefrología, Hospital General Universitario de Alicante, Alicante, España
| | - María Díaz
- Servicios de Nefrología, Hospital General Universitario de Alicante, Alicante, España
| | - Mariana Cecilia Planells
- Servicios de Radiología Intervencionista, Hospital General Universitario de Alicante, Alicante, España
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4
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Bruyère F, Pradère B, Faivre d’Arcier B, Boutin JM, Buchler M, Brichart N. Robot-assisted renal transplantation using the retroperitoneal approach (RART) with more than one year follow up: Description of the technique and results. Prog Urol 2018; 28:48-54. [DOI: 10.1016/j.purol.2017.10.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Revised: 10/09/2017] [Accepted: 10/10/2017] [Indexed: 11/30/2022]
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Damasio MB, Ording Muller LS, Piaggio G, Marks SD, Riccabona M. Imaging in pediatric renal transplantation. Pediatr Transplant 2017; 21. [PMID: 28121050 DOI: 10.1111/petr.12885] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/19/2016] [Indexed: 12/19/2022]
Abstract
Renal transplantation is the therapy of choice in children with ESKD. Radiological investigations are required in both pre- and post-transplant assessment, although there is paucity of both consensus-based statements and evidence-based imaging guidelines in pediatric renal transplantation. The phases of pediatric ESKD management that require imaging are pretransplantation recipient assessment and post-transplantation surveillance for detection of potential complications. We present suggestions for imaging algorithms for both pre- and post-transplant assessment in pediatric renal transplant recipients.
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Affiliation(s)
| | - Lil-Sofie Ording Muller
- Department of Radiology and Intervention Unit for Paediatric Radiology, Oslo University Hospital, Ullevål, Norway
| | - Giorgio Piaggio
- Department of Nephrology, Istituto Giannina Gaslini, Genoa, Italy
| | - Stephen D Marks
- Department of Paediatric Nephrology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Michael Riccabona
- Division of Pediatric Radiology, Department of Radiology, University Hospital Graz, Graz, Austria
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Ozban M, Aydin C, Dursun B, Yagci B, Birsen O, Tekin K. Post-kidney transplantation external iliac artery stenosis due to vascular clamp: report of a case. J Vasc Bras 2014. [DOI: 10.1590/jvb.2014.037] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
We report a case of right external iliac artery stenosis after kidney transplantation surgery caused by vascular clamp application injury. The patient presented with claudication of the ipsilateral lower limb and the lesion was diagnosed angiographically. The patient was treated with endovascular stent placement.
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Affiliation(s)
- Murat Ozban
- Pamukkale University School of Medicine, Turkey
| | | | | | - Baki Yagci
- Pamukkale University School of Medicine, Turkey
| | - Onur Birsen
- Pamukkale University School of Medicine, Turkey
| | - Koray Tekin
- Pamukkale University School of Medicine, Turkey
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7
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Siskind E, Lombardi P, Blum M, Tyrell R, Villa M, Kuncewitch M, Olsen EM, Alex A, Lumermann L, Bhaskaran MC, Jhaveri KD, Sachdeva M, Calderon K, Greben C, Putterman D, Gandras E, Caplin D, D’ Agostino C, Pellerito J, Coppa G, Molmenti EP. Significance of elevated transplant renal artery velocities in the postoperative renal transplant patient. Clin Transplant 2013; 27:E157-60. [DOI: 10.1111/ctr.12075] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/20/2012] [Indexed: 12/18/2022]
Affiliation(s)
- Eric Siskind
- Department of Transplantation; North Shore Long Island Jewish Health System; Hofstra University School of Medicine; Manhasset; NY; USA
| | - Pamela Lombardi
- Department of Transplantation; North Shore Long Island Jewish Health System; Hofstra University School of Medicine; Manhasset; NY; USA
| | - Mark Blum
- Department of Transplantation; North Shore Long Island Jewish Health System; Hofstra University School of Medicine; Manhasset; NY; USA
| | - Richard Tyrell
- Department of Transplantation; North Shore Long Island Jewish Health System; Hofstra University School of Medicine; Manhasset; NY; USA
| | - Manuel Villa
- Department of Transplantation; North Shore Long Island Jewish Health System; Hofstra University School of Medicine; Manhasset; NY; USA
| | - Michael Kuncewitch
- Department of Transplantation; North Shore Long Island Jewish Health System; Hofstra University School of Medicine; Manhasset; NY; USA
| | - Elizabeth M. Olsen
- Department of Transplantation; North Shore Long Island Jewish Health System; Hofstra University School of Medicine; Manhasset; NY; USA
| | - Asha Alex
- Department of Transplantation; North Shore Long Island Jewish Health System; Hofstra University School of Medicine; Manhasset; NY; USA
| | - Leandro Lumermann
- Department of Transplantation; North Shore Long Island Jewish Health System; Hofstra University School of Medicine; Manhasset; NY; USA
| | - Madhu C. Bhaskaran
- Department of Transplantation; North Shore Long Island Jewish Health System; Hofstra University School of Medicine; Manhasset; NY; USA
| | - Kenar D. Jhaveri
- Department of Transplantation; North Shore Long Island Jewish Health System; Hofstra University School of Medicine; Manhasset; NY; USA
| | - Mala Sachdeva
- Department of Transplantation; North Shore Long Island Jewish Health System; Hofstra University School of Medicine; Manhasset; NY; USA
| | - Kellie Calderon
- Department of Transplantation; North Shore Long Island Jewish Health System; Hofstra University School of Medicine; Manhasset; NY; USA
| | - Craig Greben
- Department of Transplantation; North Shore Long Island Jewish Health System; Hofstra University School of Medicine; Manhasset; NY; USA
| | - Daniel Putterman
- Department of Transplantation; North Shore Long Island Jewish Health System; Hofstra University School of Medicine; Manhasset; NY; USA
| | - Eric Gandras
- Department of Transplantation; North Shore Long Island Jewish Health System; Hofstra University School of Medicine; Manhasset; NY; USA
| | - Drew Caplin
- Department of Transplantation; North Shore Long Island Jewish Health System; Hofstra University School of Medicine; Manhasset; NY; USA
| | - Catherine D’ Agostino
- Department of Transplantation; North Shore Long Island Jewish Health System; Hofstra University School of Medicine; Manhasset; NY; USA
| | - John Pellerito
- Department of Transplantation; North Shore Long Island Jewish Health System; Hofstra University School of Medicine; Manhasset; NY; USA
| | - Gene Coppa
- Department of Transplantation; North Shore Long Island Jewish Health System; Hofstra University School of Medicine; Manhasset; NY; USA
| | - Ernesto P. Molmenti
- Department of Transplantation; North Shore Long Island Jewish Health System; Hofstra University School of Medicine; Manhasset; NY; USA
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