Refractory hypotension in an anephric patient: Immediate response to renal transplantation

A 57 yo woman underwent bilateral nephrectomy for autosomal dominant adult polycystic disease with massive organ enlargement. Despite severe pre-operative hypertension, her postoperative course was complicated by very severe debilitating hypotension, especially on dialysis, and refractory to multiple attempted interventions. Carefully planned deceased donor renal transplantation resulted in immediate post-operative normalisation of blood pressure, sustained improvement to quality of life and excellent graft function eight years later.