肾移植后静脉血栓形成的病例报告——我们能挽救移植肾吗？时间是成功的关键因素。
A case report of venous thrombosis after kidney transplantation - We can save the graft? Time is the success factor.
作者信息
Kawano Paulo Roberto, Yamamoto Hamilto Akihissa, Gerra Rodrigo, Garcia Paula Dalsoglio, Contti Mariana Moraes, Nga Hong Si, Takase Henrique Mochida, Bravin Ariane Moyses, de Andrade Luis Gustavo Modelli
机构信息
Department of Urology - UNESP, Univ Estadual Paulista, Brazil.
Department of Internal Medicine - UNESP, Univ Estadual Paulista, Brazil.
出版信息
Int J Surg Case Rep. 2017;36:82-85. doi: 10.1016/j.ijscr.2017.04.022. Epub 2017 May 19.
INTRODUCTION
Venous thrombosis is a serious surgical complication that frequently results in loss of kidney graft.
CASE PRESENTATION
We report the case of a female patient recipient of a decease kidney transplant that in the tenth postoperative presented with hematuria, graft pain and oliguria. Ultrasound examination was suggestive of venous thrombosis with abnormal doppler waveform pattern and reversal of diastolic flow. She underwent emergency surgical intervention after 2h of diagnosis. The vein thrombus was removed by perfusing the renal graft artery with 1000ml of Euro-Collins solution. The patient evolves with recovery of renal function after 1 week of the procedure DISCUSSION: Similar reports of graft rescue in the vein thrombosis are scarce and that the time of diagnosis to intervention is a determining factor.
CONCLUSION
Rapid diagnosis of exactly 2h combined with the early re-operation may be successful in preserving renal graft in cases of venous thrombosis.
引言
静脉血栓形成是一种严重的手术并发症，常导致肾移植失败。
病例报告
我们报告一例接受已故者肾移植的女性患者，术后第十天出现血尿、移植肾疼痛和少尿。超声检查提示静脉血栓形成，多普勒波形异常，舒张期血流逆转。诊断后2小时，她接受了紧急手术干预。通过向肾移植动脉灌注1000毫升欧洲柯林斯液清除静脉血栓。术后1周，患者肾功能恢复。
讨论
静脉血栓形成时挽救移植肾的类似报告很少，诊断至干预的时间是一个决定性因素。
结论
在静脉血栓形成的病例中，准确2小时的快速诊断并早期再次手术可能成功地保留肾移植。
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