Transplant with a twist: A pitfall in sonographic diagnosis of renal transplant torsion

Abstract

Torsion is an uncommon cause of impaired function in a renal transplant. We present a case of intraperitoneal transplant torsion secondary to adhesions to the left fallopian tube and ovary. Inability to confirm renal venous flow with Doppler misled to the erroneous sonographic diagnosis of renal vein thrombosis, although end diastolic flow was absent rather than reversed. The correct diagnosis was made with CT. The combination of abnormal orientation of the graft on ultrasonography, acutely impaired renal function, and abnormal Doppler study should have led to a diagnosis of transplant torsion. The case is also unusual in that the lead point was adnexal pathology. © 2017 Wiley Periodicals, Inc. J Clin Ultrasound 45:528-530, 2017.

Simultaneous Pancreas-Kidney Transplant Complicated by Kidney Allograft Torsion and Pseudoaneurysms of the Y-Allograft: A Case Report and Review of the Literature

“…Case Reports in Nephrology Some clinicians have proposed that intraperitoneal placement increases the risk of mobility with subsequent torsion and recommend that prophylactic nephropexy should be performed for patients who require an intraperitoneal kidney transplant [12,21]. Kidney allograft torsion results in a high rate of allograft loss, with only 58% of allografts salvaged (15 of 26) [7,8,[11][12][13][14][15][16][17][18][19][20][21]. Successful management depends on rapid diagnosis and surgical correction to limit ischaemic time and, as in our case, can result in a favourable allograft outcome.…”