Renal allograft compartment syndrome: an underappreciated postoperative complication.
OBJECTIVE
Renal allograft compartment syndrome (RACS) is early graft dysfunction secondary to retroperitoneal hypertension and resultant ischemia. Our purpose was to identify the incidence, therapies and outcomes of patients with RACS.


METHODS
All patients who underwent a renal transplant between 2000 and 2005 were reviewed. Patients with signs of acute allograft dysfunction were identified. RACS was diagnosed via visual allograft hypoperfusion and/or with preoperative Doppler ultrasound.


RESULTS
Among 458 patients, 11 (2%) were diagnosed with RACS. Characteristics between patient groups were similar. Five (45%) patients displayed adequate initial allograft function after transplantation. Doppler ultrasound was diagnostic. Six (55%) patients displayed poor initial allograft function and were classified as early presenters of RACS. Allograft function improved dramatically upon decompression.


CONCLUSIONS
Clinicians must remain aware of RACS as a potential diagnosis when patients display rapid deterioration in kidney performance after good initial allograft function. Doppler ultrasound is useful in diagnosing late presenters.
Ball
Chad G
CG
Department of Surgery, Foothills Medical Centre, 1403 29 St. N.W., Calgary, Alberta, Canada T2N 2T9.
Kirkpatrick
Andrew W
AW
Yilmaz
Serdar
S
Monroy
Mauricio
M
Nicolaou
Savvas
S
Salazar
Anastasio
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D003161:Compartment Syndromes / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D019299:Decompression, Surgical / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D012187:Retroperitoneal Space / Q000000981:diagnostic imaging; D012189:Retrospective Studies; D016896:Treatment Outcome; D018608:Ultrasonography, Doppler