title: A new proposal of surgical suture in case of spontaneous renal allograft rupture.
abstract: BACKGROUND
  Spontaneous kidney allograft rupture (KAR) is a rare but potentially life-threatening complication after kidney transplantation. It is associated with a high risk of graft loss and patient death. We report a new technique of surgical repair in case of KAR.
  
  
  METHODS
  A 53-year-old man transplanted due to diabetic nephropathy-related end-stage renal disease experienced a spontaneous KAR 10 days after KT. Immediate laparotomy revealed the presence of a 4-cm linear kidney fracture. Dexon 2-0 wires were used for the suture, stopping each wire with Hem-o-Loks on a cylinder of oxidized cellulose gauze, with the intent of avoiding the risk of tissue fracture caused by the suture itself. Bleeding was thus controlled. The patient experienced an uneventful course and was discharged on postoperative day 26.
  
  
  CONCLUSIONS
  According to the recent literature, graft nephrectomy for KAR is no longer considered the standard surgical treatment. A new approach to rupture repair has been proposed, providing good rates of graft and patient survival.
authors.affiliation: Transplant Unit, Department of Surgery, University of L'Aquila, San Salvatore Hospital, via L'Aquila, Italy. Electronic address: lai.quirino@libero.it.
authors.forename: Q
authors.initials: Q
authors.lastname: Lai
authors.affiliation: Transplant Unit, Department of Surgery, University of L'Aquila, San Salvatore Hospital, via L'Aquila, Italy.
authors.forename: V
authors.initials: V
authors.lastname: Rizza
authors.affiliation: Urologic Unit, San Salvatore Hospital, via Vetoio, L'Aquila, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Di Clemente
authors.affiliation: Transplant Unit, Department of Surgery, University of L'Aquila, San Salvatore Hospital, via L'Aquila, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Iesari
authors.affiliation: Transplant Unit, Department of Surgery, University of L'Aquila, San Salvatore Hospital, via L'Aquila, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Bellobono
authors.affiliation: Transplant Unit, Department of Surgery, University of L'Aquila, San Salvatore Hospital, via L'Aquila, Italy.
authors.forename: Z
authors.initials: Z
authors.lastname: Bianchi
authors.affiliation: Transplant Unit, Department of Surgery, University of L'Aquila, San Salvatore Hospital, via L'Aquila, Italy.
authors.forename: K
authors.initials: K
authors.lastname: Clemente
authors.affiliation: Transplant Unit, Department of Surgery, University of L'Aquila, San Salvatore Hospital, via L'Aquila, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Famulari
authors.affiliation: Transplant Unit, Department of Surgery, University of L'Aquila, San Salvatore Hospital, via L'Aquila, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Pisani
mesh_terms: D006488:Hemostasis, Surgical / Q000295:instrumentation*; D006801:Humans; D007668:Kidney / Q000293:injuries / Q000601:surgery*; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D012422:Rupture, Spontaneous / Q000601:surgery; D013537:Sutures; D014184:Transplantation, Homologous