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Acute allograft dysfunction mimicking thrombotic microangiopathy in kidney transplant recipient with renal infarction: case report and review of literatures

Acute allograft dysfunction is rarely observed in kidney transplantation (KT). We report an unusual case of acute allograft dysfunction mimicking thrombotic microangiopathy (TMA) in recipient with renal infarction. A 65-year-old man underwent KT from his 39-year-old son. Pre-transplant donor evaluat...

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Autores principales: Lee, Sua, Ho, Lo-Yi, Chung, Byung Ha, Park, Sun Cheol, Yang, Chul Woo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Korean Society for Transplantation 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9187041/
https://www.ncbi.nlm.nih.gov/pubmed/35770103
http://dx.doi.org/10.4285/kjt.20.0034
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author Lee, Sua
Ho, Lo-Yi
Chung, Byung Ha
Park, Sun Cheol
Yang, Chul Woo
author_facet Lee, Sua
Ho, Lo-Yi
Chung, Byung Ha
Park, Sun Cheol
Yang, Chul Woo
author_sort Lee, Sua
collection PubMed
description Acute allograft dysfunction is rarely observed in kidney transplantation (KT). We report an unusual case of acute allograft dysfunction mimicking thrombotic microangiopathy (TMA) in recipient with renal infarction. A 65-year-old man underwent KT from his 39-year-old son. Pre-transplant donor evaluation was normal except for the branches of the upper and lower pole renal arteries originating from the aorta in renal computed topographic angiography, respectively. The immediate post-transplant clinical course was uneventful, but serum creatinine (SCr) increased from 2.2 to 4.5 mg/dL, anemia and thrombocytopenia were shown, and serum lactate dehydrogenase increased to 919 U/L on the third day after transplantation. We suspected TMA, because of no evidence of acute bleeding. The laboratory parameters associated with TMA were within normal ranges. Renal magnetic resonance angiography revealed a focal wedge-shaped perfusion defect in the upper pole of the graft and renal Doppler ultrasonography showed decreased perfusion of the lower pole of the graft. Graft function improved with conservative therapy. The patient was discharged with SCr of 1.21 mg/dL. Graft function has been stable after discharge. Acute allograft infarction should be considered in the differential diagnosis of acute allograft dysfunction mimicking TMA in recipients with grafts supplied by multiple renal arteries.
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spelling pubmed-91870412022-06-28 Acute allograft dysfunction mimicking thrombotic microangiopathy in kidney transplant recipient with renal infarction: case report and review of literatures Lee, Sua Ho, Lo-Yi Chung, Byung Ha Park, Sun Cheol Yang, Chul Woo Korean J Transplant Case Report Acute allograft dysfunction is rarely observed in kidney transplantation (KT). We report an unusual case of acute allograft dysfunction mimicking thrombotic microangiopathy (TMA) in recipient with renal infarction. A 65-year-old man underwent KT from his 39-year-old son. Pre-transplant donor evaluation was normal except for the branches of the upper and lower pole renal arteries originating from the aorta in renal computed topographic angiography, respectively. The immediate post-transplant clinical course was uneventful, but serum creatinine (SCr) increased from 2.2 to 4.5 mg/dL, anemia and thrombocytopenia were shown, and serum lactate dehydrogenase increased to 919 U/L on the third day after transplantation. We suspected TMA, because of no evidence of acute bleeding. The laboratory parameters associated with TMA were within normal ranges. Renal magnetic resonance angiography revealed a focal wedge-shaped perfusion defect in the upper pole of the graft and renal Doppler ultrasonography showed decreased perfusion of the lower pole of the graft. Graft function improved with conservative therapy. The patient was discharged with SCr of 1.21 mg/dL. Graft function has been stable after discharge. Acute allograft infarction should be considered in the differential diagnosis of acute allograft dysfunction mimicking TMA in recipients with grafts supplied by multiple renal arteries. The Korean Society for Transplantation 2020-12-31 2020-12-31 /pmc/articles/PMC9187041/ /pubmed/35770103 http://dx.doi.org/10.4285/kjt.20.0034 Text en Copyright © 2020 The Korean Society for Transplantation https://creativecommons.org/licenses/by-nc/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0 (https://creativecommons.org/licenses/by-nc/4.0/) ) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Lee, Sua
Ho, Lo-Yi
Chung, Byung Ha
Park, Sun Cheol
Yang, Chul Woo
Acute allograft dysfunction mimicking thrombotic microangiopathy in kidney transplant recipient with renal infarction: case report and review of literatures
title Acute allograft dysfunction mimicking thrombotic microangiopathy in kidney transplant recipient with renal infarction: case report and review of literatures
title_full Acute allograft dysfunction mimicking thrombotic microangiopathy in kidney transplant recipient with renal infarction: case report and review of literatures
title_fullStr Acute allograft dysfunction mimicking thrombotic microangiopathy in kidney transplant recipient with renal infarction: case report and review of literatures
title_full_unstemmed Acute allograft dysfunction mimicking thrombotic microangiopathy in kidney transplant recipient with renal infarction: case report and review of literatures
title_short Acute allograft dysfunction mimicking thrombotic microangiopathy in kidney transplant recipient with renal infarction: case report and review of literatures
title_sort acute allograft dysfunction mimicking thrombotic microangiopathy in kidney transplant recipient with renal infarction: case report and review of literatures
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9187041/
https://www.ncbi.nlm.nih.gov/pubmed/35770103
http://dx.doi.org/10.4285/kjt.20.0034
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