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October 1976

Venous Embolus to a Transplanted Kidney: Diagnosis and Treatment

Author Affiliations

From the Division of General Surgery (Vascular-Trauma-Transplantation) (Dr Mandel), and the departments of medicine (Dr Mattern) and radiology (Dr Staab), University of North Carolina at Chapel Hill, Division of Health Affairs.

Arch Surg. 1976;111(10):1135-1138. doi:10.1001/archsurg.1976.01360280093015

• We are reporting the first case, to our knowledge, of a venous embolus to a transplanted kidney. The embolus occurred five days after transplantation of a cadaver kidney in a 31-year-old woman who was receiving estrogen-progesterone therapy for menorrhagia. Five hours after the acute onset of left flank pain and anuria, the embolus was identified at the anastomosis of the donor renal vein to the external iliac vein. The embolus was manipulated distally in the external iliac vein and excluded by proximal division of the vein. Recovery was eventually complete, despite two major postoperative complications, acute tubular necrosis and a perirenal hematoma secondary to heparin sodium therapy. Radionuclide scanning was critically important in establishing the diagnosis and in assessing the potential for the kidney to recover from acute tubular necrosis. On the basis of this experience, we believe that prompt surgical intervention is indicated for acute venous occlusion.

(Arch Surg 111:1135-1138, 1976)