Carrasco A, Díaz C, Flores J C, Briones E, Otipka N
Department of Nephrology, Hospital Militar, Santiago, Chile.
Transplant Proc. 2008 Nov;40(9):3259-60. doi: 10.1016/j.transproceed.2008.03.122. Epub 2008 Jun 30.
Allograft renal vein thrombosis (RVT) is an uncommon but potentially catastrophic complication. Although it usually occurs in the early posttransplant period and is associated with surgical complications or vascular rejection, it may develop later, when it is generally related with a hypercoagulable state. Typical clinical presentation is sudden oligoanuric acute renal failure, and hematuria, with a painful and swollen renal allograft. Confirmation of the diagnosis requires Doppler ultrasound and computed tomography. Herein we have reported a successfully treated case of late RVT that developed in an allograft with recurrent membranous nephropathy associated with the nephrotic syndrome. The patient fully recovered renal graft function a few days after presentation, which was related to anticoagulant therapy. We demonstrated complete recanalization of the venous thrombosis.
同种异体肾静脉血栓形成(RVT)是一种罕见但可能具有灾难性的并发症。虽然它通常发生在移植后的早期,与手术并发症或血管排斥反应有关,但也可能在后期出现,此时通常与高凝状态有关。典型的临床表现是突然出现少尿性急性肾衰竭、血尿,伴有移植肾疼痛和肿胀。诊断的确立需要多普勒超声和计算机断层扫描。在此,我们报告了一例成功治疗的晚期RVT病例,该病例发生在患有复发性膜性肾病并伴有肾病综合征的同种异体移植肾中。患者在就诊几天后移植肾功能完全恢复,这与抗凝治疗有关。我们证实静脉血栓完全再通。