Subcapsular hematoma evacuation as a method of evaluating injured kidneys for transplant.
BACKGROUND
Approximately one-third of organ donors in the United States are trauma victims. In general, kidneys with large subcapsular hematomas are not used for transplant because of the possibility of significant parenchymal injury. A large subcapsular renal hematoma may cause scarring resulting in renal parenchymal compression and development of the Page syndrome.


OBJECTIVE
To elucidate a successful method of evaluating kidneys subject to trauma, while also possibly preventing further damage and improving their function.


METHODS
Data were collected from the donor kidney pool of the New York Organ Donor Network from January 2006 through July 2007. Four kidneys during that period were determined to have significant subcapsular hematomas. Surgical intervention was undertaken and outcomes after transplantation were reviewed.


METHODS
Four of the kidneys underwent a surgical procedure to drain the subcapsular hematoma allowing assessment of the underlying renal parenchyma. All 4 of these kidneys were deemed transplantable. After transplantation, 3 of the 4 kidneys had immediate function and did not require dialysis. The remaining kidney was removed as a result of primary nonfunction.


CONCLUSIONS
The described surgical intervention allows the transplant surgeon to accurately assess the extent of damage to a traumatized kidney while possibly preventing further damage to the kidney.
Yushkov
Yuriy
Y
New York Organ Donor Network, New York, USA.
Hoffman
Allison
A
Giudice
Anthony
A
D004210:Dissection / Q000379:methods; D046148:Donor Selection / Q000379:methods*; D004322:Drainage / Q000379:methods*; D005500:Follow-Up Studies; D006406:Hematoma / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D007674:Kidney Diseases / Q000175:diagnosis / Q000601:surgery*; D016030:Kidney Transplantation; D009392:Nephrectomy / Q000379:methods; D009518:New York; D009926:Organ Preservation / Q000379:methods; D020858:Tissue and Organ Harvesting / Q000379:methods; D016896:Treatment Outcome