Saravanakumar Sanjeev, Skousen Madeline R, Cornell Lynn D, Shankaranarayanan Divya, Serrano Rodriguez Pablo
Transplant, George Washington University School of Medicine and Health Sciences, Washington, D.C., USA.
Pathology, Mayo Clinic, Rochester, USA.
Cureus. 2024 Dec 11;16(12):e75562. doi: 10.7759/cureus.75562. eCollection 2024 Dec.
A 31-year-old male patient with a history of sickle cell disease (SCD) with stage V chronic kidney disease (CKD) presented for a deceased donor kidney transplant. During surgery, the transplanted kidney showed mottling and limited cortical flow, raising concerns for an intraoperative sickle cell crisis versus hyperacute rejection. Postoperative imaging revealed decreased vascularity, and the patient was treated with RBC exchange. Pathology confirmed thrombotic microangiopathy without acute rejection. The patient's condition improved with supportive care, and he was discharged by postoperative day 10. This case highlights the complexity of managing SCD patients undergoing organ transplantation, with a focus on intraoperative challenges and postoperative care.
一名31岁患有镰状细胞病（SCD）且处于慢性肾脏病（CKD）Ⅴ期的男性患者前来接受已故供体肾移植。手术过程中，移植肾出现斑点状且皮质血流受限，引发了关于术中镰状细胞危象与超急性排斥反应的担忧。术后影像学检查显示血管减少，患者接受了红细胞置换治疗。病理证实为血栓性微血管病，无急性排斥反应。患者经支持治疗后病情好转，术后第10天出院。该病例凸显了管理接受器官移植的SCD患者的复杂性，重点在于术中挑战及术后护理。
