Vascular complications post renal transplant – Case report

Abstract

IntroductionSevere acute graft dysfunction due to vascular complication need prompt decision regarding the type and need of intervention. But many times imaging may not give the definitive diagnosis. Vascular complications continue to account for about 3–15% of the cases of graft dysfunction. Aims and objectivesWe analyzed the clinical features, investigations and intervention done in the cases of possible acute vascular complications post renal transplant. Methods50 patients who have undergone renal transplant at Bombay hospital were studied. Three cases having graft dysfunction in early postoperative period with reported significant vascular pathology on imaging were analyzed.First case had severe renal transplant graft dysfunction on 4th postoperative day (POD) with angiography suggestive of renal artery narrowing requiring re-exploration. Second case had iliac vein thrombosis close to renal vein anastomosis managed conservatively with good outcome. Third case was reported on Doppler ultrasound as compromised renal blood flow. Conclusion3 out of 50 renal transplants at our institute over 15 months follow-up had been reported as early vascular complications. One patient required re-exploration. Appropriate evaluation and management is the key to salvage the graft. Atherosclerosis (donor/recipient), acute rejection, delayed graft function increase this risk.