Renal vein thrombosis after kidney transplantation : a study of 3 cases from a series of 635 kidney transplantations

Abstract EN

Background & Objectives.: Renal vein thrombosis (RVT) after kidney transplantation (KT) is a rare and early complication.

It has been noted to occur in 4-6 % of cases.

The object of this study is to report the incidence of RVT after KT in our experience, presenting symptoms, modality of diagnosis, types of treatment, and outcome of our cases.

Methods: Between October 1985 and July 2003, 635 KT were performed in two centers, the Al Mouassat University Hospital (478 cases from living related donors) and the Kidney Hospital (157 cases from living and unrelated donors).

Pulsed and color Doppler ultrasound was available for our patients after April 1998.

It was routinely performed for every patient in the post-operative period and repeated when there was any renal disorder.

All cases of RVT in this series were studied whether they were diagnosed by surgery or by color Doppler.

Results: 3 cases of RVT were diagnosed in our series (0.47%, 2 cases from Al-Mouassat University Hospital and one case from the Kidney Hospital).

All of these patients are treated with CsA.

RVT was related to anatomical factors in two patients.

The symptoms included anuria two hours after transplantation in patient number 1, hematuria then anuria 24 hrs after transplantation in patient number 2, and pain and anuria 48 hrs after transplantation in patient number 3.

The diagnosis was suspected clinically in patient number 1 with immediate laparatomy and removal of the clot, which allowed the salvage of the transplant.

In the second and third patients, the diagnosis was made by pulsed and color Doppler,! with subsequent transplant nephrectomy.

Conclusion: The incidence rate of RVT in our series is less than reported in the literature possibly because we do not have a program of cadaver transplantation.

Pulsed and color Doppler imaging permits early and easy diagnosis.

Emergency surgery may salvage the graft when it is performed within 1-2 hours after the formation of the thrombosis.

Transplant nephrectomy is often done because of the delay in the diagnosis.

This prevents gi-aft rupture and relieves the patient's pain.