Salvaging kidneys with renal allograft compartment syndrome

Authors

  • Munish Kumar Heer,

    1.  Newcastle Transplant Unit, Division of Surgery, John Hunter Hospital, Newcastle, NSW, Australia
    2.  School of Medicine and Population Health, Faculty of Health Sciences, University of Newcastle, Newcastle, NSW, Australia
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  • Paul Raymond Trevillian,

    1.  Newcastle Transplant Unit, Division of Surgery, John Hunter Hospital, Newcastle, NSW, Australia
    2.  School of Medicine and Population Health, Faculty of Health Sciences, University of Newcastle, Newcastle, NSW, Australia
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  • David Bradley Hardy,

    1.  Department of Cardiovascular Medicine, Division of Medicine, John Hunter Hospital, Newcastle, NSW, Australia
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  • Adrian Donald Hibberd

    1.  Newcastle Transplant Unit, Division of Surgery, John Hunter Hospital, Newcastle, NSW, Australia
    2.  School of Medicine and Population Health, Faculty of Health Sciences, University of Newcastle, Newcastle, NSW, Australia
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  • Conflict of interest
    There is no conflict of interest declared by any author.

Munish K. Heer, Newcastle Transplant Unit, Division of Surgery, John Hunter Hospital, Hunter New England Local Health Network, Locked Bag Number1, Hunter Region Mail Centre, NSW 2310, Australia. Tel.: +61 249214326; fax +61 249214336; e-mail: munish.heer@hnehealth.nsw.gov.au

Summary

Renal allograft compartment syndrome is an under recognized cause of early allograft dysfunction which can be reversed by early intervention. It occurs early after renal transplantation where closure of the anterior abdominal wall seems to compress the transplant in the limited retroperitoneal space. The literature about this syndrome in renal transplantation is sparse. Our report describes the diagnostic criteria and the management of two renal transplant recipients with this syndrome. Its diagnosis depends upon duplex vascular scan findings of reversed or absent diastolic flow in the renal vasculature in the absence of any perigraft collection or severe acute tubular necrosis. In our hands emergency laparotomy, decompression of the transplant and closure with interposition mesh salvaged these kidneys.

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