Complete devascularisation of transplant kidney

Case contributed by Dr Balint Botz

Presentation

Chronic CKD. Cadaveric renal transplant performed two days earlier. Minimal urine output and elevated creatinine.

Patient Data

Age: 40

The B-mode appearance of the transplanted kidney showed no gross abnormality. However, neither arterial, nor arterial vascularity could be discerned in the organ using either color or power Doppler imaging. The occasional speckled color signals most apparent on the cine acquisition represent motion-induced flash artifacts as the color velocity scale and gain were adjusted to increase sensitivity.  The supplying renal artery and vein could not be identified. 

Case Discussion

A laparotomy was subsequently performed, during which the kidney was found to be entirely necrotic and the renal vein filled with thrombus. The organ was resected and sent to pathology which showed that the renal artery was also completely filled with blood clot. Histology confirmed necrosis secondary to devascularization without signs immune-mediated acute rejection. 

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Case information

rID: 68454
Published: 1st Jun 2019
Last edited: 4th Jun 2019
Inclusion in quiz mode: Included
Institution: University of Pécs

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