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Shearing-force injury of a kidney transplant graft during cesarean section: a case report and review of the literature
BACKGROUND: With an increasing number of reproductive-aged women undergoing renal transplantation coupled with improved fertility post-transplantation, more women are becoming pregnant with a kidney transplant in place. This leads to increased risk of perinatal complications such as pre-eclampsia, g...
Autores principales: | , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6423748/ https://www.ncbi.nlm.nih.gov/pubmed/30885165 http://dx.doi.org/10.1186/s12882-019-1281-6 |
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author | Gordon, Catherine E. Tatsis, Vasiliki |
author_facet | Gordon, Catherine E. Tatsis, Vasiliki |
author_sort | Gordon, Catherine E. |
collection | PubMed |
description | BACKGROUND: With an increasing number of reproductive-aged women undergoing renal transplantation coupled with improved fertility post-transplantation, more women are becoming pregnant with a kidney transplant in place. This leads to increased risk of perinatal complications such as pre-eclampsia, gestational diabetes, preterm delivery and Cesarean section. Given that kidney transplants are often placed extra-peritoneally in the iliac fossa, there is also a risk of damage to the transplanted kidney at the time of Cesarean section. CASE PRESENTATION: We present a case of shearing-force injury to a transplanted kidney at the time of repeat Cesarean section due to adherence of the organ to the overlying fascia. This is the first known case of an injury by this mechanism. CONCLUSION: Pre-operative planning with organ mapping and incision planning is imperative, with consideration for a vertical midline incision to avoid direct or shearing forces on the transplant kidney. Preoperative collaboration with the Transplant Surgery team is also important so they are available in case of emergency or need for intraoperative consultation. |
format | Online Article Text |
id | pubmed-6423748 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-64237482019-03-28 Shearing-force injury of a kidney transplant graft during cesarean section: a case report and review of the literature Gordon, Catherine E. Tatsis, Vasiliki BMC Nephrol Case Report BACKGROUND: With an increasing number of reproductive-aged women undergoing renal transplantation coupled with improved fertility post-transplantation, more women are becoming pregnant with a kidney transplant in place. This leads to increased risk of perinatal complications such as pre-eclampsia, gestational diabetes, preterm delivery and Cesarean section. Given that kidney transplants are often placed extra-peritoneally in the iliac fossa, there is also a risk of damage to the transplanted kidney at the time of Cesarean section. CASE PRESENTATION: We present a case of shearing-force injury to a transplanted kidney at the time of repeat Cesarean section due to adherence of the organ to the overlying fascia. This is the first known case of an injury by this mechanism. CONCLUSION: Pre-operative planning with organ mapping and incision planning is imperative, with consideration for a vertical midline incision to avoid direct or shearing forces on the transplant kidney. Preoperative collaboration with the Transplant Surgery team is also important so they are available in case of emergency or need for intraoperative consultation. BioMed Central 2019-03-18 /pmc/articles/PMC6423748/ /pubmed/30885165 http://dx.doi.org/10.1186/s12882-019-1281-6 Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Case Report Gordon, Catherine E. Tatsis, Vasiliki Shearing-force injury of a kidney transplant graft during cesarean section: a case report and review of the literature |
title | Shearing-force injury of a kidney transplant graft during cesarean section: a case report and review of the literature |
title_full | Shearing-force injury of a kidney transplant graft during cesarean section: a case report and review of the literature |
title_fullStr | Shearing-force injury of a kidney transplant graft during cesarean section: a case report and review of the literature |
title_full_unstemmed | Shearing-force injury of a kidney transplant graft during cesarean section: a case report and review of the literature |
title_short | Shearing-force injury of a kidney transplant graft during cesarean section: a case report and review of the literature |
title_sort | shearing-force injury of a kidney transplant graft during cesarean section: a case report and review of the literature |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6423748/ https://www.ncbi.nlm.nih.gov/pubmed/30885165 http://dx.doi.org/10.1186/s12882-019-1281-6 |
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