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Allograft loss from acute Page kidney secondary to trauma after kidney transplantation

We report a rare case of allograft loss from acute Page kidney secondary to trauma that occurred 12 years after kidney transplantation. A 67-year-old Caucasian male with a past surgical history of kidney transplant presented to the emergency department at a local hospital with left lower abdominal t...

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Autores principales: Takahashi, Kazuhiro, Prashar, Rohini, Putchakayala, Krishna G, Kane, William J, Denny, Jason E, Kim, Dean Y, Malinzak, Lauren E
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Baishideng Publishing Group Inc 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5324033/
https://www.ncbi.nlm.nih.gov/pubmed/28280700
http://dx.doi.org/10.5500/wjt.v7.i1.88
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author Takahashi, Kazuhiro
Prashar, Rohini
Putchakayala, Krishna G
Kane, William J
Denny, Jason E
Kim, Dean Y
Malinzak, Lauren E
author_facet Takahashi, Kazuhiro
Prashar, Rohini
Putchakayala, Krishna G
Kane, William J
Denny, Jason E
Kim, Dean Y
Malinzak, Lauren E
author_sort Takahashi, Kazuhiro
collection PubMed
description We report a rare case of allograft loss from acute Page kidney secondary to trauma that occurred 12 years after kidney transplantation. A 67-year-old Caucasian male with a past surgical history of kidney transplant presented to the emergency department at a local hospital with left lower abdominal tenderness. He recalled that his cat, which weighs 15 lbs, jumped on his abdomen 7 d prior. On physical examination, a small tender mass was noticed at the incisional site of the kidney transplant. He was producing a normal amount of urine without hematuria. His serum creatinine level was slightly elevated from his baseline. Computer tomography revealed a large subscapular hematoma around the transplant kidney. The patient was observed to have renal trauma grade II at the hospital over a period of three days, and he was finally transferred to a transplant center after his urine output significantly decreased. Doppler ultrasound demonstrated an extensive peri-allograft hypoechoic area and abnormal waveforms with absent arterial diastolic flow and a patent renal vein. Despite surgical decompression, the allograft failed to respond appropriately due to the delay in surgical intervention. This is the third reported case of allograft loss from acute Page kidney following kidney transplantation. This case reinforces that kidney care differs if the kidney is solitary or a transplant. Early recognition and aggressive treatments are mandatory, especially in a case with Doppler signs that are suggestive of compression.
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spelling pubmed-53240332017-03-09 Allograft loss from acute Page kidney secondary to trauma after kidney transplantation Takahashi, Kazuhiro Prashar, Rohini Putchakayala, Krishna G Kane, William J Denny, Jason E Kim, Dean Y Malinzak, Lauren E World J Transplant Case Report We report a rare case of allograft loss from acute Page kidney secondary to trauma that occurred 12 years after kidney transplantation. A 67-year-old Caucasian male with a past surgical history of kidney transplant presented to the emergency department at a local hospital with left lower abdominal tenderness. He recalled that his cat, which weighs 15 lbs, jumped on his abdomen 7 d prior. On physical examination, a small tender mass was noticed at the incisional site of the kidney transplant. He was producing a normal amount of urine without hematuria. His serum creatinine level was slightly elevated from his baseline. Computer tomography revealed a large subscapular hematoma around the transplant kidney. The patient was observed to have renal trauma grade II at the hospital over a period of three days, and he was finally transferred to a transplant center after his urine output significantly decreased. Doppler ultrasound demonstrated an extensive peri-allograft hypoechoic area and abnormal waveforms with absent arterial diastolic flow and a patent renal vein. Despite surgical decompression, the allograft failed to respond appropriately due to the delay in surgical intervention. This is the third reported case of allograft loss from acute Page kidney following kidney transplantation. This case reinforces that kidney care differs if the kidney is solitary or a transplant. Early recognition and aggressive treatments are mandatory, especially in a case with Doppler signs that are suggestive of compression. Baishideng Publishing Group Inc 2017-02-24 2017-02-24 /pmc/articles/PMC5324033/ /pubmed/28280700 http://dx.doi.org/10.5500/wjt.v7.i1.88 Text en ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved. http://creativecommons.org/licenses/by-nc/4.0/ This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial.
spellingShingle Case Report
Takahashi, Kazuhiro
Prashar, Rohini
Putchakayala, Krishna G
Kane, William J
Denny, Jason E
Kim, Dean Y
Malinzak, Lauren E
Allograft loss from acute Page kidney secondary to trauma after kidney transplantation
title Allograft loss from acute Page kidney secondary to trauma after kidney transplantation
title_full Allograft loss from acute Page kidney secondary to trauma after kidney transplantation
title_fullStr Allograft loss from acute Page kidney secondary to trauma after kidney transplantation
title_full_unstemmed Allograft loss from acute Page kidney secondary to trauma after kidney transplantation
title_short Allograft loss from acute Page kidney secondary to trauma after kidney transplantation
title_sort allograft loss from acute page kidney secondary to trauma after kidney transplantation
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5324033/
https://www.ncbi.nlm.nih.gov/pubmed/28280700
http://dx.doi.org/10.5500/wjt.v7.i1.88
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