title: [Multiple complications after renal transplantation].
abstract: This is the case of a 32-year-old male patient, diagnosed with end stage renal disease secondary to a focal and segmental glomerulonephritis. After four years of haemodialysis, he received a renal graft from a cadaveric donor. During the following sixteen years, he developped many different complications. In the early post-transplant period, he developed a severe acute tubular necrosis and two episodes of acute rejection took place, both of them with later recovery. Among the outstanding infectious complications were a virus herpes zoster dorsal infection and a Pseudomonas aeruginosa nosocomial pneumonia. Twelve months later, a series of severe digestive complications took place: cholecystitis that required cholecystectomy, pancreatic pseudocyst which required laparotomy because of an abdominal complication, two separate episodes of upper digestive bleeding that finally required gastric surgery, and an hemorrhagic subphrenic abscess that required a second laparotomy. Currently he has developed a calcified chronic pancreatitis. Moreover, metabolic complications must be mentioned carbohydrate intolerance, cataracts and an avascular bone necrosis, all of them closely related to the immunosuppressive therapy. In spite of these multiple complications, he mantains a good renal function and his quality of life is acceptable.
authors.affiliation: Servicio de Nefrología, Clínica Universitaria de Navarra, Pamplona. jmanrique@unav.es
authors.forename: J
authors.initials: J
authors.lastname: Manrique
authors.forename: E
authors.initials: E
authors.lastname: Rossich
authors.forename: A
authors.initials: A
authors.lastname: Hernández Sierra
mesh_terms: D000328:Adult; D001379:Azathioprine / Q000009:adverse effects; D002386:Cataract / Q000139:chemically induced; D002764:Cholecystitis / Q000209:etiology / Q000601:surgery; D042883:Choledocholithiasis / Q000601:surgery; D016572:Cyclosporine / Q000009:adverse effects; D005271:Femur Head Necrosis / Q000139:chemically induced; D006471:Gastrointestinal Hemorrhage / Q000209:etiology; D005923:Glomerulosclerosis, Focal Segmental / Q000150:complications / Q000601:surgery; D018149:Glucose Intolerance / Q000139:chemically induced; D006084:Graft Rejection / Q000209:etiology; D006562:Herpes Zoster / Q000209:etiology; D006801:Humans; D016867:Immunocompromised Host; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D007676:Kidney Failure, Chronic / Q000209:etiology / Q000601:surgery; D016030:Kidney Transplantation; D007683:Kidney Tubular Necrosis, Acute / Q000139:chemically induced; D008297:Male; D010192:Pancreatic Pseudocyst / Q000209:etiology / Q000601:surgery; D018410:Pneumonia, Bacterial / Q000209:etiology; D011183:Postoperative Complications / Q000209:etiology* / Q000601:surgery; D011241:Prednisone / Q000009:adverse effects; D011552:Pseudomonas Infections / Q000209:etiology; D013369:Subphrenic Abscess / Q000209:etiology / Q000601:surgery
chemical_list: D007166:Immunosuppressive Agents; D016572:Cyclosporine; D001379:Azathioprine; D011241:Prednisone