Conservative management of an extensive renal graft subcapsular hematoma arising during living donor nephrectomy. Role of Doppler sonographic posttransplant follow-up.

We report a case of subcapsular hematoma (SH) of a kidney graft arising during minimal-incision living-donor nephrectomy. SH covered at least two-thirds of the cortical surface. Capsulotomy was not done because it was deemed too risky. In the immediate postoperative period, a rapid deterioration of graft function was observed associated with Doppler sonographic evidence of graft compression. However, in the following days, spontaneous resolution of SH and progressive improvement of Doppler findings was observed, which preceded full recovery of graft function. Conservative management seemed a valid approach of this complication in this case where Doppler sonography proved essential for the follow-up.