Ulu Ozturk Funda, Uslu Nihal, Yilmaz Akcay Eda, Haberal Mehmet
Department of Radiology, Baskent University School of Medicine, Ankara, Turkey.
Exp Clin Transplant. 2017 Feb;15(Suppl 1):244-246. doi: 10.6002/ect.mesot2016.P117.
A 47-year-old male patient underwent living-related renal transplant. On day 3 posttransplant, without evidence of associated clinical symptoms, the patient's serum creatinine levels had increased. The patient was given immunosuppressive medication, and a followup Doppler ultrasonography revealed hypoechoic areas in the inferior pole of the renal parenchyma. Eventually, on day 25, there was no perfusion in the superior and inferior poles of the transplanted kidney. No venous flow was shown in the middle segment, and only arterial vascularization with a high resistive index and negative diastolic phase was observed. Renal biopsy showed acute humoral rejection. This was interpreted as venous thrombosis secondary to acute humoral rejection. Tissue plasminogen activator infusion, plasmapheresis, and hemodialysis were administered. After 1.5 months, arterial flow returned to its normal pattern and the renal allograft recovered by gaining back its full vascularity at the end of month 8.
一名47岁男性患者接受了亲属活体肾移植。移植后第3天，患者血清肌酐水平升高，且无相关临床症状。患者接受了免疫抑制药物治疗，后续的多普勒超声检查显示肾实质下极有低回声区。最终，在第25天，移植肾的上极和下极均无灌注。中段未见静脉血流，仅观察到动脉血管化，阻力指数高且舒张期为负。肾活检显示急性体液排斥反应。这被解释为急性体液排斥反应继发的静脉血栓形成。给予组织纤溶酶原激活剂输注、血浆置换和血液透析治疗。1.5个月后，动脉血流恢复正常模式，移植肾在第8个月末恢复了全部血管供应，功能恢复。
