title: Late spontaneous decapsulation of the kidney graft in a patient with hepatitis C and treated with sirolimus: possible pathophysiological association in a rare complication.
abstract: Late decapsulation with fluid collection is a rare complication of renal transplantation with deleterious effects on kidney function. Its physiopathology is unclear but there might be an association with mammalian target of rapamycin (m-TOR) inhibitors, especially in patients with chronic hepatitis C. We report a case of late spontaneous decapsulation 12 years after kidney transplant in a patient infected with hepatitis C under treatment with sirolimus. He underwent marsupialisation of the collection, sirolimus was converted to cyclosporine and hepatitis C treatment was performed with success. This is the first successful case report of late spontaneous decapsulation of the kidney graft in a patient with hepatitis C.
authors.affiliation: Department of Nephrology, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.
authors.forename: Rita
authors.initials: R
authors.lastname: Leal
authors.affiliation: Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.
authors.forename: Helena
authors.initials: H
authors.lastname: Pinto
authors.affiliation: Department of Nephrology, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.|Universidade de Coimbra Faculdade de Medicina, Coimbra, Portugal.
authors.forename: Rui
authors.initials: R
authors.lastname: Alves
authors.affiliation: Universidade de Coimbra Faculdade de Medicina, Coimbra, Portugal.|Department of Urology and Kidney Transplantation, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.
authors.forename: Arnaldo
authors.initials: A
authors.lastname: Figueiredo
mesh_terms: D000998:Antiviral Agents / Q000627:therapeutic use; D016572:Cyclosporine / Q000627:therapeutic use; D057915:Drug Substitution; D006084:Graft Rejection / Q000517:prevention & control*; D019698:Hepatitis C, Chronic / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D007674:Kidney Diseases / Q000150:complications / Q000000981:diagnostic imaging*; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging*; D011239:Prednisolone / Q000627:therapeutic use; D012307:Risk Factors; D020123:Sirolimus / Q000627:therapeutic use*; D014057:Tomography, X-Ray Computed
chemical_list: D000998:Antiviral Agents; D007166:Immunosuppressive Agents; D016572:Cyclosporine; D011239:Prednisolone; D020123:Sirolimus