胰肾联合移植并发肾扭转及y -异体假性动脉瘤1例报告及文献复习。

Sarah L Tan, Rachel Y P Tan, Gabrielle Cehic, Michael Wu, John Kanellis, Jeffrey Barbara
{"title":"胰肾联合移植并发肾扭转及y -异体假性动脉瘤1例报告及文献复习。","authors":"Sarah L Tan,&nbsp;Rachel Y P Tan,&nbsp;Gabrielle Cehic,&nbsp;Michael Wu,&nbsp;John Kanellis,&nbsp;Jeffrey Barbara","doi":"10.1155/2022/1748141","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>We report and review the literature of two rare complications of simultaneous pancreas-kidney transplantation (SPKT) occurring in one patient. <i>Case Report</i>. A 39-year-old man with dialysis-dependent kidney failure secondary to type 1 diabetes mellitus underwent successful SPKT in October 2018. Three months later, he presented with an acute kidney injury (AKI) and returned to dialysis. Kidney scintigraphy showed a central photopenic region, and angiograms showed absent flow in the kidney transplant artery without treatable thrombus and the incidental finding of two pseudoaneurysms of the pancreatic <i>Y</i>-graft. He remained dialysis-dependent for three weeks before spontaneous partial recovery of allograft function; repeat kidney scintigraphy showed significant improvement in perfusion. However, in April 2019 he was readmitted with a sudden deterioration in kidney allograft function again necessitating haemodialysis. Repeat imaging confirmed that the kidney allograft had shifted from the left iliac fossa to the midline. He underwent surgical exploration, during which torsion of the kidney allograft was confirmed and a nephropexy was performed. The kidney allograft was originally implanted in the left retroperitoneum via a midline transperitoneal approach, which likely predisposed it to torsion. The pseudoaneurysms of the pancreatic <i>Y</i>-graft were managed conservatively, and surveillance imaging demonstrated that they remained stable in size. The patient regained reasonable kidney allograft function (estimated glomerular filtration rate, eGFR, of 45 mL/min) and maintained normal pancreatic allograft function.</p><p><strong>Conclusion: </strong>Kidney allograft torsion should be considered post-SPKT in patients with AKI and absent arterial flow. Although most case reports describe surgical management of pseudoaneurysms post-SPKT, our case demonstrates successful conservative management.</p>","PeriodicalId":9604,"journal":{"name":"Case Reports in Nephrology","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9759385/pdf/","citationCount":"0","resultStr":"{\"title\":\"Simultaneous Pancreas-Kidney Transplant Complicated by Kidney Allograft Torsion and Pseudoaneurysms of the <i>Y</i>-Allograft: A Case Report and Review of the Literature.\",\"authors\":\"Sarah L Tan,&nbsp;Rachel Y P Tan,&nbsp;Gabrielle Cehic,&nbsp;Michael Wu,&nbsp;John Kanellis,&nbsp;Jeffrey Barbara\",\"doi\":\"10.1155/2022/1748141\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>We report and review the literature of two rare complications of simultaneous pancreas-kidney transplantation (SPKT) occurring in one patient. <i>Case Report</i>. A 39-year-old man with dialysis-dependent kidney failure secondary to type 1 diabetes mellitus underwent successful SPKT in October 2018. Three months later, he presented with an acute kidney injury (AKI) and returned to dialysis. Kidney scintigraphy showed a central photopenic region, and angiograms showed absent flow in the kidney transplant artery without treatable thrombus and the incidental finding of two pseudoaneurysms of the pancreatic <i>Y</i>-graft. He remained dialysis-dependent for three weeks before spontaneous partial recovery of allograft function; repeat kidney scintigraphy showed significant improvement in perfusion. However, in April 2019 he was readmitted with a sudden deterioration in kidney allograft function again necessitating haemodialysis. Repeat imaging confirmed that the kidney allograft had shifted from the left iliac fossa to the midline. He underwent surgical exploration, during which torsion of the kidney allograft was confirmed and a nephropexy was performed. The kidney allograft was originally implanted in the left retroperitoneum via a midline transperitoneal approach, which likely predisposed it to torsion. The pseudoaneurysms of the pancreatic <i>Y</i>-graft were managed conservatively, and surveillance imaging demonstrated that they remained stable in size. The patient regained reasonable kidney allograft function (estimated glomerular filtration rate, eGFR, of 45 mL/min) and maintained normal pancreatic allograft function.</p><p><strong>Conclusion: </strong>Kidney allograft torsion should be considered post-SPKT in patients with AKI and absent arterial flow. Although most case reports describe surgical management of pseudoaneurysms post-SPKT, our case demonstrates successful conservative management.</p>\",\"PeriodicalId\":9604,\"journal\":{\"name\":\"Case Reports in Nephrology\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2022-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9759385/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Case Reports in Nephrology\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1155/2022/1748141\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Case Reports in Nephrology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1155/2022/1748141","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0

摘要

背景:我们报道并回顾了发生在一名患者的两种罕见的胰肾联合移植(SPKT)并发症。病例报告。2018年10月,一名患有继发于1型糖尿病的透析依赖性肾衰竭的39岁男性成功接受了SPKT治疗。3个月后,他出现急性肾损伤(AKI),并返回透析。肾显像显示中央光性减退区,血管造影显示肾移植动脉无血流,无可治疗的血栓,y型胰腺移植处偶然发现两个假性动脉瘤。在同种异体移植物功能自发部分恢复之前,他仍然依赖透析三周;重复肾显像显示灌注明显改善。然而,2019年4月,他再次因同种异体肾脏功能突然恶化而再次入院,需要进行血液透析。重复成像证实肾移植已从左髂窝转移到中线。他接受了手术探查,在此期间证实了肾移植扭转并进行了肾固定。同种异体肾移植最初通过中线经腹膜入路植入左侧腹膜后,这可能使其易发生扭转。胰腺y型移植物的假性动脉瘤被保守处理,监视成像显示它们的大小保持稳定。患者恢复了合理的肾移植功能(估计肾小球滤过率,eGFR为45 mL/min),并维持了正常的胰腺移植功能。结论:急性肾损伤合并无动脉血流的患者在spkt后应考虑同种异体肾移植扭转。虽然大多数病例报告描述手术治疗假性动脉瘤后spkt,我们的病例显示成功的保守管理。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

摘要图片

摘要图片

摘要图片

查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
Simultaneous Pancreas-Kidney Transplant Complicated by Kidney Allograft Torsion and Pseudoaneurysms of the Y-Allograft: A Case Report and Review of the Literature.

Background: We report and review the literature of two rare complications of simultaneous pancreas-kidney transplantation (SPKT) occurring in one patient. Case Report. A 39-year-old man with dialysis-dependent kidney failure secondary to type 1 diabetes mellitus underwent successful SPKT in October 2018. Three months later, he presented with an acute kidney injury (AKI) and returned to dialysis. Kidney scintigraphy showed a central photopenic region, and angiograms showed absent flow in the kidney transplant artery without treatable thrombus and the incidental finding of two pseudoaneurysms of the pancreatic Y-graft. He remained dialysis-dependent for three weeks before spontaneous partial recovery of allograft function; repeat kidney scintigraphy showed significant improvement in perfusion. However, in April 2019 he was readmitted with a sudden deterioration in kidney allograft function again necessitating haemodialysis. Repeat imaging confirmed that the kidney allograft had shifted from the left iliac fossa to the midline. He underwent surgical exploration, during which torsion of the kidney allograft was confirmed and a nephropexy was performed. The kidney allograft was originally implanted in the left retroperitoneum via a midline transperitoneal approach, which likely predisposed it to torsion. The pseudoaneurysms of the pancreatic Y-graft were managed conservatively, and surveillance imaging demonstrated that they remained stable in size. The patient regained reasonable kidney allograft function (estimated glomerular filtration rate, eGFR, of 45 mL/min) and maintained normal pancreatic allograft function.

Conclusion: Kidney allograft torsion should be considered post-SPKT in patients with AKI and absent arterial flow. Although most case reports describe surgical management of pseudoaneurysms post-SPKT, our case demonstrates successful conservative management.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
Case Reports in Nephrology
Case Reports in Nephrology Medicine-Nephrology
CiteScore
1.70
自引率
0.00%
发文量
32
期刊最新文献
Unusual Cases of Monoclonal Gammopathy of Renal Significance. ANCA-Negative Pauci-Immune Glomerulonephritis Associated with Bartonella Endocarditis. Acute Peritoneal Dialysis in a Patient with Severe Uremic Syndrome and Multiple Hemodialysis Access Failure. The Autoimmune/Inflammatory Syndrome Induced by Adjuvants (ASIA), Associated with Renal Compromise and Cutaneous Calcinosis: A Case Report and Literature Review An Elderly Case of Minimal Change Nephrotic Syndrome: Correlation between Renal Tubular Dysfunction and the Onset of Oliguric Acute Kidney Injury Requiring Hemodialysis.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1