[Femoral arteriovenous fistula and transplant malfunction after allogeneic kidney transplantation. A case report].
This case report deals with the clinical history of a 52-year-old woman who suffered from delayed graft function and ischaemic pain after a technically successful renal transplantation. The past history of the patient revealed that coronary catheters had repeatedly been used for investigation and treatment of myocardial infarctions. The clinical investigation reported here revealed a typical auscultatory result with an arteriovenous (AV) fistula in the right upper limb. After performing a digital arterial angiography, an AV fistula between the femoral artery and vein was demonstrated. Operative occlusion of the fistula increased the perfusion of the kidney graft and the right limb. The patient recovered without wound infection and could leave the hospital with the transplanted kidney functioning well. This case report demonstrates that persistence of AV fistulas after angiographic investigations is rare. Operative occlusion of these lesions should be performed before kidney transplantation to avoid steal phenomena and disturbed would healing.
Reek
C
C
Urologische Universitätsklinik Hamburg-Eppendorf.
Tenschert
W
W
Cremaschi
L
L
Nicolas
V
V
Wolf
W
W
Fernandez
S
S
D015901:Angiography, Digital Subtraction; D001164:Arteriovenous Fistula / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D005263:Femoral Artery / Q000000981:diagnostic imaging / Q000601:surgery*; D005268:Femoral Vein / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D007511:Ischemia / Q000000981:diagnostic imaging / Q000601:surgery; D007668:Kidney / Q000098:blood supply*; D016030:Kidney Transplantation / Q000502:physiology; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000601:surgery*; D012086:Reoperation