Cyclosporine-Related Hemolytic-Uremic Syndrome in Kidney Graft Recipients: Clinical and Histomorphologic Evaluation

Bren, Andrej; Kandus, A.; Buturović, J; Koselj, M; Pavlovcic, S Kaplan; Ponikvar, Rafael; Kovač, Damjan; Lindič, Jelka; Vizjak, Alenka; Ferluga, D

doi:10.1016/s0041-1345(98)00209-7

Cited by 15 publications

(1 citation statement)

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“…[11] A study on a patient with HUS revealed classic findings of renal failure, hemolytic anemia, schistocytes, and thrombocytopenia. Cyclosporin [12] or tacrolimus-associated HUS [13] following renal transplantation has been reported. Increased incidence of acute thrombosis of the transplanted renal artery is also associated with increased use of cyclosporin.…”

Section: Discussionmentioning

confidence: 99%

Acute thrombosis of a transplanted renal artery after gastric ulcer bleeding in a patient with a long-term well-functioning renal allograft

Leu

Wei³

et al. 2016

Medicine

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Background:Acute thrombosis of a transplanted renal artery is a serious vascular complication following renal allograft transplantation, which usually occurs within the first month after transplantation and often results in graft loss. It rarely occurs beyond the first month, except in a rejected kidney or in a kidney with high-grade transplant renal artery stenosis.Result:A 65-year-old male with a history of type 2 diabetes mellitus, hypertension, pulmonary tuberculosis, and end-stage renal disease was previously treated with hemodialysis (HD). He received a kidney transplant and had a well-functioning graft for 2 years. He presented to our emergency department with gastric ulcer bleeding and received treatment involving an endoscopic submucosal epinephrine injection, a proton pump inhibitor, and blood transfusions. Nine days later, he complained of sudden lower abdominal pain and had acute anuric kidney failure. Renal ultrasonography revealed an absence of blood flow to the allograft kidney. Renal artery angiogram demonstrated complete occlusion of the transplanted renal artery. After thrombectomy and percutaneous transluminal angioplasty (PTA) with stent placement, 60% stenosis of the proximal renal artery with distal perfusion was noted. However, his graft function did not improve, and he received HD again. Histopathology of the transplanted kidney revealed ischemic tubular nephropathy with focal infarction without rejection.Conclusion:This is the first case of acute thrombosis of the transplanted renal artery following gastric ulcer bleeding in a patient with a long-term well-functioning graft kidney.

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Section: Discussionmentioning

confidence: 99%