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KMID : 0359919990180061003
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Korean Journal of Nephrology
1999 Volume.18 No. 6 p.1003 ~ p.1007
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A Case of Spontaneous Rupture of Renal Allograft
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1윤병옥/1Byung Ok Yoon
1오명진/1김재한/1서기현/1양동호/1홍세용/2김의한/1Myiung Jin Oh/1Jae Han Kim/1Ki Hyun Seo/1Dong Ho Yung/1Sei Uyng Hong/2Euy Han Kim
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Abstract
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-Abstract-
Spontaneous renal allograft rupture is an uncommon complication of renal
transplantation, but it represents a life-threatening emergency that requires prompt
recognition and treatment. The incidence of spontaneous renal allograft rupture is
variable and range between 3.6 and 9.6 percent of all transplants. In the majority of
cases the rupture is associated with acute rejection episodes and with renal vein
thrombosis. Most frequently, the allograft rupture occurs within the first 2 weeks of
transplantation. In addition, most ruptures reported have occurred in cadaveric renal
allograft. Debate on the management of such allograft salvage versus transplant
nephrectomy. It appears that the recent trend is toward performing surgical repair of the
graft if the rupture is secondary to rejection and no evidence of renal vein thrombosis;
otherwise, graft nephrectomy be done.
We report a case of spontaneous renal allograft rupture due to renal vein thrombosis
occurred in a 21-year-old woman 6 days after transplantation. Unusual severe localized
pain, swelling over at allograft site, and hypotension, a triad frequently seen in renal
allograft rupture, were present. Management by graft nephrectomy was inevitable
because of the patient's downhill course.
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