title: Renal transplant in children with previous inferior vena cava thrombosis.
abstract: Our experience with renal transplantation in children with inferior vena cava thrombosis is presented in this study. Of the 238 children who have received renal transplants at our institution, four had IVC thrombosis (discovered during pretransplant evaluation: three patients; found at surgery: one patient). The pretransplant US evaluation diagnosis of IVC thrombosis in three patients was confirmed by transjugular retrograde cavography. There were no signs of hypercoagulability or IVC thrombosis symptoms prior to diagnosis in any patient. The graft was implanted in a left orthotopic position in three patients. Venous drainage was attained to the infrahepatic vena cava or native renal vein after ipsilateral nephrectomy. The renal artery of the graft was anastomosed to the aorta. In one patient, the graft was placed in the left iliac fossa. Patient and graft survival are 100%. Three grafts are functioning normally after a mean follow-up of 3.7 yr. The graft placed in the iliac fossa has moderate dysfunction due to high pressure venous outflow. Children with IVC thrombosis can be successfully transplanted orthotopically. Candidates with any suspicious-looking occlusion on ultrasound should be studied by retrograde venography to confirm diagnosis prior to transplantation.
authors.affiliation: Pediatric Urology, University Hospital La Paz, Madrid, Spain. mjmu@hotmail.com
authors.forename: Maria Jose
authors.initials: MJ
authors.lastname: Martinez-Urrutia
authors.forename: Pedro Lopez
authors.initials: PL
authors.lastname: Pereira
authors.forename: Luis Avila
authors.initials: LA
authors.lastname: Ramirez
authors.forename: Roberto Lobato
authors.initials: RL
authors.lastname: Romera
authors.forename: Angel Alonso
authors.initials: AA
authors.lastname: Melgar
authors.forename: Enrique Jaureguizar
authors.initials: EJ
authors.lastname: Monereo
authors.forename: Juan Tovar
authors.initials: JT
authors.lastname: Larrucea
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D005500:Follow-Up Studies; D006085:Graft Survival; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000601:surgery*; D016030:Kidney Transplantation / Q000379:methods*; D018810:Magnetic Resonance Angiography; D010690:Phlebography; D011379:Prognosis; D012189:Retrospective Studies; D013997:Time Factors; D018608:Ultrasonography, Doppler; D014656:Vascular Surgical Procedures; D014682:Vena Cava, Inferior; D020246:Venous Thrombosis / Q000150:complications* / Q000175:diagnosis / Q000601:surgery