Salvaging kidneys with renal allograft compartment syndrome.
Renal allograft compartment syndrome is an under recognized cause of early allograft dysfunction which can be reversed by early intervention. It occurs early after renal transplantation where closure of the anterior abdominal wall seems to compress the transplant in the limited retroperitoneal space. The literature about this syndrome in renal transplantation is sparse. Our report describes the diagnostic criteria and the management of two renal transplant recipients with this syndrome. Its diagnosis depends upon duplex vascular scan findings of reversed or absent diastolic flow in the renal vasculature in the absence of any perigraft collection or severe acute tubular necrosis. In our hands emergency laparotomy, decompression of the transplant and closure with interposition mesh salvaged these kidneys.
Newcastle Transplant Unit, Division of Surgery, John Hunter Hospital, Newcastle, NSW, Australia. munish.heer@hnehealth.nsw.gov.au
Munish Kumar
MK
Heer
Paul Raymond
PR
Trevillian
David Bradley
DB
Hardy
Adrian Donald
AD
Hibberd
D003161:Compartment Syndromes / Q000209:etiology / Q000601:surgery*; D061345:Early Medical Intervention; D005260:Female; D006801:Humans; D007668:Kidney / Q000098:blood supply* / Q000601:surgery; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D012187:Retroperitoneal Space / Q000601:surgery; D013526:Surgical Mesh; D014184:Transplantation, Homologous / Q000009:adverse effects