title: Pulmonary embolus originating from renal vein stump thrombus after laparoscopic living donor nephrectomy: case report.
abstract: BACKGROUND
  Pulmonary embolism (PE) is an uncommon, life-threatening complication after living donor nephrectomy (LDN), and is considered among the most common causes for donor mortality. Most cases of postoperative PEs are thought to originate in deep venous thrombosis (DVT) of the lower extremities.
  
  
  METHODS
  A 56-year-old, healthy woman underwent laparoscopic left LDN. Her postoperative course was complicated by PE, presenting at postoperative day 7. Doppler ultrasonography of her lower extremities did not demonstrate DVT. Both transthoracic echocardiogram and contrast-enhanced computed tomography demonstrated a floating thrombus within the inferior vena cava (IVC) originating from a thrombus in the left renal vein stump. Symptoms resolved with systemic anticoagulation. Repeat transesophageal echocardiography demonstrated resolution of the IVC thrombus.
  
  
  CONCLUSIONS
  Thrombus originating in left renal vein stump should be considered in patients who develop PE after LDN, especially when lower extremity DVT is not demonstrated.
authors.affiliation: Recanati-Miller Transplant Institute, The Mount Sinai Medical Center, New York, New York.
authors.forename: N
authors.initials: N
authors.lastname: Lubezky
authors.affiliation: Recanati-Miller Transplant Institute, The Mount Sinai Medical Center, New York, New York.
authors.forename: E H
authors.initials: EH
authors.lastname: Stern
authors.affiliation: Recanati-Miller Transplant Institute, The Mount Sinai Medical Center, New York, New York.
authors.forename: V
authors.initials: V
authors.lastname: Nair
authors.affiliation: Recanati-Miller Transplant Institute, The Mount Sinai Medical Center, New York, New York.
authors.forename: D
authors.initials: D
authors.lastname: Herron
authors.affiliation: Recanati-Miller Transplant Institute, The Mount Sinai Medical Center, New York, New York.
authors.forename: E
authors.initials: E
authors.lastname: Chin
authors.affiliation: Recanati-Miller Transplant Institute, The Mount Sinai Medical Center, New York, New York.
authors.forename: M
authors.initials: M
authors.lastname: Palese
authors.affiliation: Recanati-Miller Transplant Institute, The Mount Sinai Medical Center, New York, New York.
authors.forename: D
authors.initials: D
authors.lastname: LaPointe Rudow
authors.affiliation: Recanati-Miller Transplant Institute, The Mount Sinai Medical Center, New York, New York.
authors.forename: V
authors.initials: V
authors.lastname: Delaney
authors.affiliation: Recanati-Miller Transplant Institute, The Mount Sinai Medical Center, New York, New York.
authors.forename: M
authors.initials: M
authors.lastname: Goldstein
authors.affiliation: Recanati-Miller Transplant Institute, The Mount Sinai Medical Center, New York, New York.
authors.forename: S
authors.initials: S
authors.lastname: Florman
authors.affiliation: Recanati-Miller Transplant Institute, The Mount Sinai Medical Center, New York, New York. Electronic address: juan.rocca@mountsinai.org.
authors.forename: J P
authors.initials: JP
authors.lastname: Rocca
mesh_terms: D017548:Echocardiography, Transesophageal; D005260:Female; D006801:Humans; D010535:Laparoscopy; D019520:Living Donors; D008875:Middle Aged; D009392:Nephrectomy / Q000009:adverse effects* / Q000379:methods; D011655:Pulmonary Embolism / Q000209:etiology; D012082:Renal Veins; D020858:Tissue and Organ Harvesting / Q000009:adverse effects; D014057:Tomography, X-Ray Computed; D016306:Vena Cava Filters; D014682:Vena Cava, Inferior; D020246:Venous Thrombosis / Q000175:diagnosis