Fathi T, Samhan M, Gawish A, Donia F, Al-Mousawi M
Hamed Al-Essa Organ Transplant Centre, Kuwait.
Transplant Proc. 2007 May;39(4):1120-1. doi: 10.1016/j.transproceed.2007.03.043.
Renal vein thrombosis (RVT) is an uncommon but serious complication. It usually occurs early after surgery. While compression of the renal vein is the most common cause, early rejection and hemostatic defects are other known causes. The symptoms are nonspecific and diagnosis is often delayed. Ultrasonography and renal isotope scan findings may resemble acute rejection or acute tubular necrosis.
We retrospectively reviewed the records of 684 recipients who were transplated between November 1993 and May 2006. The diagnosis of RVT was suspected by an unexplained drop in urine output, rise in serum creatinine, or hematuria, and confirmed by Doppler ultrasound and isotope scanning. Urgent exploration was performed in all suspected cases.
Seven incidences of biopsy-proven RVT were encountered, including 3 associated with hematoma and 1 with rejection. Four grafts were from cadaveric donors. Three grafts were salvaged.
The incidence of RVT in the present series was 1%. All cases developed in the first 2 weeks after transplantation. It was more common in adults, in female recipients, and in cadaveric grafts. Early diagnosis and intervention were the keys to salvage.
肾静脉血栓形成（RVT）是一种少见但严重的并发症。它通常在术后早期发生。虽然肾静脉受压是最常见的原因，但早期排斥反应和止血缺陷也是其他已知原因。症状不具特异性，诊断往往延迟。超声检查和肾同位素扫描结果可能类似于急性排斥反应或急性肾小管坏死。
我们回顾性分析了1993年11月至2006年5月间684例接受移植患者的记录。RVT的诊断通过尿量不明原因减少、血清肌酐升高或血尿怀疑，并经多普勒超声和同位素扫描确诊。所有疑似病例均进行了紧急探查。
共发现7例经活检证实的RVT，其中3例与血肿相关，1例与排斥反应相关。4例移植物来自尸体供体。3例移植物得以挽救。
本系列中RVT的发生率为1%。所有病例均在移植后2周内发生。在成人、女性受者和尸体移植物中更常见。早期诊断和干预是挽救的关键。
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