Delayed Hemorrhage in Kidney Transplantation: A Life-threatening Condition.

IF 0.3 Q4 TRANSPLANTATION
International Journal of Organ Transplantation Medicine Pub Date : 2018-01-01 Epub Date: 2018-02-01
S Gooran, A Javid, G Pourmand
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引用次数: 0

Abstract

One of the most catastrophic complications of kidney transplantation is non-traumatic delayed bleeding caused by arterial dissection and pseudoaneurysm, endangering the survival of the graft and the patient. Herein, we discuss the management of this condition in 3 cases. The patients included 2 men, 30 and 47 years old, and a 33-year-old woman, who developed a massive hemorrhage in the second week after kidney transplant. All our patients were diabetic for more than 5 years. Massive hemorrhage occurred in the second week without any trauma or precipitating factor. A combination of antibiotic therapy, surgery and interventional procedures was required and all three transplanted kidneys inevitably had to be removed. Although there were trivial signs of infection, considerable pus and infectious and necrotic tissue were drained during graft nephrectomy. A high index of suspicion is necessary for the timely diagnosis of arterial dissection and aneurysm. Aggressive treatment with arterial drug-eluting stents and surgical drainage are necessary in order to prevent potentially fatal complications.

Abstract Image

Abstract Image

肾移植迟发性出血:一种危及生命的疾病。
肾移植最严重的并发症之一是由动脉夹层和假性动脉瘤引起的非外伤性迟发性出血,危及移植物和患者的生存。在此,我们讨论3例这种情况的处理。患者包括两名男性,年龄分别为30岁和47岁,以及一名33岁的女性,她在肾移植后第二周出现大出血。所有患者均患有糖尿病5年以上。第二周发生大出血,无外伤或促发因素。需要结合抗生素治疗、手术和介入治疗,移植的三个肾脏不可避免地必须切除。虽然有轻微的感染迹象,但在移植肾切除术期间,大量的脓液和感染坏死组织被排出。高的怀疑指数对于及时诊断动脉夹层和动脉瘤是必要的。积极治疗动脉药物洗脱支架和手术引流是必要的,以防止潜在的致命并发症。
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来源期刊
CiteScore
1.60
自引率
0.00%
发文量
0
审稿时长
12 weeks
期刊介绍: The International Journal of Organ Transplantation Medicine (IJOTM) is a quarterly peer-reviewed English-language journal that publishes high-quality basic sciences and clinical research on transplantation. The scope of the journal includes organ and tissue donation, procurement and preservation; surgical techniques, innovations, and novelties in all aspects of transplantation; genomics and immunobiology; immunosuppressive drugs and pharmacology relevant to transplantation; graft survival and prevention of graft dysfunction and failure; clinical trials and population analyses in the field of transplantation; transplant complications; cell and tissue transplantation; infection; post-transplant malignancies; sociological and ethical issues and xenotransplantation.
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