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Renal Infarction during Anticoagulant Therapy after Living Donor Liver Transplantation

INTRODUCTION: Liver transplant recipients are at risk for complications of vascular thrombosis. The reconstructed hepatic artery and portal vein thrombosis potentially result in hepatic failure and graft loss. Renal infarction is a rare clinical condition, but in severe cases, it may lead to renal f...

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Autores principales: Onda, Shinji, Shiba, Hiroaki, Takano, Yuki, Furukawa, Kenei, Hata, Taigo, Yanaga, Katsuhiko
Formato: Online Artículo Texto
Lenguaje:English
Publicado: S. Karger AG 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5968266/
https://www.ncbi.nlm.nih.gov/pubmed/29805361
http://dx.doi.org/10.1159/000488526
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author Onda, Shinji
Shiba, Hiroaki
Takano, Yuki
Furukawa, Kenei
Hata, Taigo
Yanaga, Katsuhiko
author_facet Onda, Shinji
Shiba, Hiroaki
Takano, Yuki
Furukawa, Kenei
Hata, Taigo
Yanaga, Katsuhiko
author_sort Onda, Shinji
collection PubMed
description INTRODUCTION: Liver transplant recipients are at risk for complications of vascular thrombosis. The reconstructed hepatic artery and portal vein thrombosis potentially result in hepatic failure and graft loss. Renal infarction is a rare clinical condition, but in severe cases, it may lead to renal failure. We herein report a case of renal infarction after living donor liver transplantation (LDLT) during anticoagulant therapy. CASE PRESENTATION: A 60-year-old woman with end-stage liver disease due to primary biliary cholangitis underwent LDLT with splenectomy. Postoperatively, tacrolimus, mycophenolate mofetil, and steroid were used for initial immunosuppression therapy. On postoperative day (POD) 5, enhanced computed tomography (CT) revealed splenic vein thrombosis, and anticoagulant therapy with heparin followed by warfarin was given. Follow-up enhanced CT on POD 20 incidentally demonstrated right renal infarction. The patient's renal function was unchanged and the arterial flow was good, and the splenic vein thrombosis resolved. At 4 months postoperatively, warfarin was discontinued, but she developed recurrent splenic vein thrombosis 11 months later, and warfarin was resumed. As of 40 months after transplantation, she discontinued warfarin and remains well without recurrence of splenic vein thrombosis or renal infarction. CONCLUSION: Renal infarction is a rare complication of LDLT. In this case, renal infarction was incidentally diagnosed during anticoagulant therapy and was successfully treated.
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spelling pubmed-59682662018-05-25 Renal Infarction during Anticoagulant Therapy after Living Donor Liver Transplantation Onda, Shinji Shiba, Hiroaki Takano, Yuki Furukawa, Kenei Hata, Taigo Yanaga, Katsuhiko Case Rep Gastroenterol Single Case INTRODUCTION: Liver transplant recipients are at risk for complications of vascular thrombosis. The reconstructed hepatic artery and portal vein thrombosis potentially result in hepatic failure and graft loss. Renal infarction is a rare clinical condition, but in severe cases, it may lead to renal failure. We herein report a case of renal infarction after living donor liver transplantation (LDLT) during anticoagulant therapy. CASE PRESENTATION: A 60-year-old woman with end-stage liver disease due to primary biliary cholangitis underwent LDLT with splenectomy. Postoperatively, tacrolimus, mycophenolate mofetil, and steroid were used for initial immunosuppression therapy. On postoperative day (POD) 5, enhanced computed tomography (CT) revealed splenic vein thrombosis, and anticoagulant therapy with heparin followed by warfarin was given. Follow-up enhanced CT on POD 20 incidentally demonstrated right renal infarction. The patient's renal function was unchanged and the arterial flow was good, and the splenic vein thrombosis resolved. At 4 months postoperatively, warfarin was discontinued, but she developed recurrent splenic vein thrombosis 11 months later, and warfarin was resumed. As of 40 months after transplantation, she discontinued warfarin and remains well without recurrence of splenic vein thrombosis or renal infarction. CONCLUSION: Renal infarction is a rare complication of LDLT. In this case, renal infarction was incidentally diagnosed during anticoagulant therapy and was successfully treated. S. Karger AG 2018-04-24 /pmc/articles/PMC5968266/ /pubmed/29805361 http://dx.doi.org/10.1159/000488526 Text en Copyright © 2018 by S. Karger AG, Basel http://creativecommons.org/licenses/by-nc/4.0/ This article is licensed under the Creative Commons Attribution-NonCommercial-4.0 International License (CC BY-NC) (http://www.karger.com/Services/OpenAccessLicense). Usage and distribution for commercial purposes requires written permission.
spellingShingle Single Case
Onda, Shinji
Shiba, Hiroaki
Takano, Yuki
Furukawa, Kenei
Hata, Taigo
Yanaga, Katsuhiko
Renal Infarction during Anticoagulant Therapy after Living Donor Liver Transplantation
title Renal Infarction during Anticoagulant Therapy after Living Donor Liver Transplantation
title_full Renal Infarction during Anticoagulant Therapy after Living Donor Liver Transplantation
title_fullStr Renal Infarction during Anticoagulant Therapy after Living Donor Liver Transplantation
title_full_unstemmed Renal Infarction during Anticoagulant Therapy after Living Donor Liver Transplantation
title_short Renal Infarction during Anticoagulant Therapy after Living Donor Liver Transplantation
title_sort renal infarction during anticoagulant therapy after living donor liver transplantation
topic Single Case
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5968266/
https://www.ncbi.nlm.nih.gov/pubmed/29805361
http://dx.doi.org/10.1159/000488526
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