Liquefaction of renal allograft: An unprecedented complication in transplantation medicine.

IF 0.8 Q4 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
Salman J Arain, Adam H Morrell
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引用次数: 0

Abstract

Background: Renal transplantation stands as the gold standard treatment for end-stage renal disease, offering improved quality of life and increased survival compared to dialysis. However, despite its advantages, renal allograft failure can occur, necessitating careful management to mitigate associated complications. Instances of liquefaction of the transplanted kidney are exceedingly rare, posing unique challenges to clinicians in the management of allograft failure. Existing literature highlights the complexities surrounding decisions regarding dialysis reinitiation, immunosuppression management, and the potential need for transplant nephrectomy in patients with failed renal allografts.

Case presentation: A 52-year-old Caucasian female with a complex medical history including stage 5 chronic kidney disease, non-ST-segment elevation myocardial infarction, hypertrophic cardiomyopathy with mild left ventricular systolic dysfunction, atrial fibrillation, and a history of cardiac arrest resulting in hypoxic brain injury, presented with a unique complication following renal transplantation. Imaging studies revealed complete breakdown and liquefaction of the transplanted kidney in the right iliac fossa. Despite interventions such as ultrasound-guided aspiration and drainage, the patient's condition continued to deteriorate.

Conclusion: This case highlights a rare occurrence of allograft liquefaction following renal transplantation, emphasising the need for vigilance in monitoring transplant recipients for uncommon complications. The management of such cases requires a multidisciplinary approach, considering factors such as dialysis reinitiation timing, immunosuppression management, and the potential need for transplant nephrectomy. Further research is warranted to elucidate the pathophysiology and optimal management strategies for unique complications such as allograft liquefaction, underscoring the importance of individualised treatment approaches in complex clinical scenarios.

同种异体肾移植液化:移植医学中前所未有的并发症。
背景:肾移植是终末期肾病的金标准治疗方法,与透析相比,肾移植可改善生活质量,提高生存率。然而,尽管有其优点,同种异体肾移植也可能发生衰竭,需要仔细处理以减轻相关并发症。移植肾液化的情况极为罕见,这给临床医生处理同种异体移植失败提出了独特的挑战。现有文献强调了透析重新开始的复杂性,免疫抑制管理,以及移植肾移植失败患者移植肾切除术的潜在需求。病例介绍:一名52岁白人女性,有复杂的病史,包括5期慢性肾病、非st段抬高型心肌梗死、肥厚性心肌病伴轻度左心室收缩功能障碍、心房颤动和心脏骤停导致缺氧脑损伤,在肾移植后出现了一个独特的并发症。影像学检查显示移植肾在右髂窝完全破裂和液化。尽管采取了超声引导下的抽吸引流等干预措施,患者的病情仍在继续恶化。结论:本病例突出了肾移植后异体移植物液化的罕见发生,强调了监测移植受者罕见并发症的必要性。此类病例的处理需要多学科的方法,考虑透析重新开始时间、免疫抑制管理和移植肾切除术的潜在需求等因素。进一步的研究需要阐明异体移植物液化等独特并发症的病理生理学和最佳管理策略,强调在复杂的临床情况下个性化治疗方法的重要性。
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来源期刊
Ultrasound
Ultrasound RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-
CiteScore
1.70
自引率
0.00%
发文量
55
期刊介绍: Ultrasound is the official journal of the British Medical Ultrasound Society (BMUS), a multidisciplinary, charitable society comprising radiologists, obstetricians, sonographers, physicists and veterinarians amongst others.
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