Chung J, Caumartin Y, Warren J, Luke P P W
Department of Surgery, Division of Urology, University of Western Ontario, Canada.
Am J Transplant. 2008 Jun;8(6):1323-8. doi: 10.1111/j.1600-6143.2008.02215.x. Epub 2008 Apr 29.
The acute Page kidney phenomenon occurs as a consequence of external compression of the renal parenchyma leading to renal ischemia and hypertension. Between January 2000 and September 2007, 550 kidney transplants and 518 ultrasound-guided kidney biopsies were performed. During that time, four recipients developed acute oligo-anuria following ultrasound-guided allograft biopsy. Emergent doppler-ultrasounds were performed demonstrating absence of diastolic flow as well as a sub-capsular hematoma of the kidney. Prompt surgical exploration with allograft capsulotomy was performed in all cases. Immediately after capsulotomy, intraoperative Doppler study demonstrated robust return of diastolic flow. Three patients maintained good graft function, and one kidney was lost due to acute antibody-mediated rejection. We conclude that postbiopsy anuria associated with a subcapsular hematoma and acute absence of diastolic flow on doppler ultrasound should be considered pathognomonic of APK. All renal transplant specialists should be able to recognize this complication, because immediate surgical decompression can salvage the allograft.
急性佩奇肾现象是肾实质受到外部压迫导致肾缺血和高血压的结果。2000年1月至2007年9月期间，共进行了550例肾移植和518例超声引导下肾活检。在此期间，4名受者在超声引导下进行同种异体肾活检后出现急性少尿-无尿。紧急进行多普勒超声检查，显示无舒张期血流以及肾包膜下血肿。所有病例均立即进行了同种异体肾包膜切开术的紧急手术探查。包膜切开术后立即进行术中多普勒研究，显示舒张期血流强劲恢复。3例患者移植肾功能良好，1例肾因急性抗体介导的排斥反应而丢失。我们得出结论，活检后无尿伴包膜下血肿和多普勒超声检查显示舒张期血流急性消失应被视为急性佩奇肾的特征性表现。所有肾移植专科医生都应能够识别这种并发症，因为立即进行手术减压可以挽救移植肾。
