Jacob E T, Sidi A A, Heim M D
Int Surg. 1982 Jan-Mar;67(1):75-7.
A single kidney was harvested from a cadaveric donor who had sustained cranio-cerebral injury and blunt abdominal trauma. The contra-lateral kidney was discarded because of direct injury. Following 11 hours of cold ischemia, the allograft was transplanted into a 13-year-old recipient without complications. Increased vesical hemorrhage was noted immediately transfusions were necessary. Angiography, cystoscopy and groin exploration all failed to elucidate the cause of the nephrorrhagy. Graftectomy was eventually performed on the 9th post-transplant day and on sagittal section of the kidney, a veno-calyceal fistula was discovered. The conventional diagnostic methods are only capable of revealing gross pathology of the allograft and in the absence of cortical fractures, the visual assessment and perfusion characteristics of the kidney are not sufficiently reliable. Particular attention should be paid to kidneys removed from donors who have sustained even localized abdominal injuries and, in all probability, kidneys originating from such donors should be discarded.
从一名患有颅脑损伤和钝性腹部创伤的尸体供体获取了一个肾脏。对侧肾脏因直接损伤而被丢弃。经过11小时的冷缺血后，将同种异体移植物移植到一名13岁的受者体内，未出现并发症。立即发现膀胱出血增加，需要输血。血管造影、膀胱镜检查和腹股沟探查均未能明确肾出血的原因。最终在移植后第9天进行了移植肾切除术，在肾脏矢状切片上发现了一个静脉肾盂瘘。传统的诊断方法仅能揭示同种异体移植物的大体病理情况，在没有皮质骨折的情况下，肾脏的视觉评估和灌注特征不够可靠。应特别注意从即使遭受局部腹部损伤的供体获取的肾脏，很可能应丢弃来自此类供体的肾脏。
