Endovascular Recanalization of Late Venous Thrombosis After Kidney Transplantation by Off-Label Application of Ultrasound Mechanical Thrombolysis (EKOS): A Case Report

IF 0.8 4区医学 Q4 IMMUNOLOGY

Transplantation proceedings Pub Date : 2025-09-01 DOI:10.1016/j.transproceed.2025.07.011

Alessandro Baggi , Leonardo Centonze , Angela Alfonsi , Federico De Stefano , Francesco Morelli , Marco Solcia , Andrea Lauterio

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引用次数: 0

Abstract

Background

Kidney transplantation (KT) represents the best treatment option for patients with end-stage renal disease (ESTD). Graft venous thrombosis is a rare but serious complication. Early diagnosis and prompt treatment are crucial to preserve graft function and survival.

Case Presentation

The patient underwent DBD KT for stage V ESRD. The postoperative course was uneventful, without medical or surgical complications. Fifteen days after surgery, the patient presented to the emergency department with anuria. A CT scan demonstrated a complete thrombosis of the renal vein. The thrombosis was managed with an off-label application of the EKOS device.

Discussion

There are currently no established guidelines for the management of RVTPT. Surgical intervention, including thrombectomy by renal venotomy, anastomotic repair, or graft explant is the recommended approach in early VT. In contrast, thrombolytic therapy is generally the preferred treatment for thrombosis occurring in the late post-transplant period. The off-label application of ultrasound-mechanical thrombolysis (EKOS) for late renal vein thrombosis after kidney transplantation offers a promising, minimally invasive alternative.

Conclusions

This experience highlights the importance of a multidisciplinary approach in the management of surgical and transplant patients.

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超说明书应用超声机械溶栓治疗肾移植术后晚期静脉血栓血管内再通1例。

背景：肾移植（KT）是终末期肾病（ESTD）患者的最佳治疗选择。移植物静脉血栓形成是一种罕见但严重的并发症。早期诊断和及时治疗是保持移植物功能和存活的关键。病例介绍：患者因V期ESRD接受了DBD KT治疗。术后过程平稳，无药物或手术并发症。术后15天，患者因无尿而就诊于急诊科。CT扫描显示肾静脉血栓形成。血栓形成是通过标签外应用EKOS设备进行管理的。讨论：目前尚无关于RVTPT管理的既定指南。手术干预，包括肾静脉切开术取栓、吻合口修复或移植外植体是早期室性心动过速的推荐方法。而对于移植后后期血栓形成，通常首选溶栓治疗。超声机械溶栓（EKOS）在肾移植后晚期肾静脉血栓的非适应症应用提供了一种有前途的微创替代方案。结论：这一经验强调了多学科方法在外科和移植患者管理中的重要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Transplantation proceedings 医学-免疫学

CiteScore

1.70

自引率

0.00%

发文量

502

审稿时长

60 days

期刊介绍： Transplantation Proceedings publishes several different categories of manuscripts, all of which undergo extensive peer review by recognized authorities in the field prior to their acceptance for publication. The first type of manuscripts consists of sets of papers providing an in-depth expression of the current state of the art in various rapidly developing components of world transplantation biology and medicine. These manuscripts emanate from congresses of the affiliated transplantation societies, from Symposia sponsored by the Societies, as well as special Conferences and Workshops covering related topics. Transplantation Proceedings also publishes several special sections including publication of Clinical Transplantation Proceedings, being rapid original contributions of preclinical and clinical experiences. These manuscripts undergo review by members of the Editorial Board. Original basic or clinical science articles, clinical trials and case studies can be submitted to the journal?s open access companion title Transplantation Reports.