J Korean Soc Transplant.  2017 Jun;31(2):87-90. 10.4285/jkstn.2017.31.2.87.

Late Onset Renal Vein Thrombosis after Kidney Transplantation

• Park WY
• Kang SS
• Jin K
• Park SB
• Han S

• KMID: 2385534
• DOI: http://doi.org/10.4285/jkstn.2017.31.2.87

Abstract

Renal vein thrombosis is a rare but serious cause of graft loss in kidney transplant recipients that is usually associated with early surgical complications. Here, we report a rare case of sudden development of late onset renal vein thrombosis after kidney transplantation. A 32-year-old man underwent deceased kidney transplantation 2 years prior. Oliguria and pain suddenly developed at the allograft site along with an elevated serum creatinine level. Doppler ultrasound showed absence of venous flow in the transplanted kidney. Magnetic resonance imaging showed thrombosis from the allograft vein to the anastomosis with the left common iliac vein and a swollen allograft kidney. The patient underwent anticoagulation with unfractionated heparin and warfarin. Serum creatinine normalized and renal vein thrombosis disappeared after 3 months of treatment. Late-onset renal vein thrombosis is rare; however, early detection and treatment are very important to restore renal allograft function.

Keyword

Kidney transplantation; Renal veins; Thrombosis; Complication

MeSH Terms

Adult
Allografts
Creatinine
Heparin
Humans
Iliac Vein
Kidney Transplantation*
Kidney*
Magnetic Resonance Imaging
Oliguria
Renal Veins*
Thrombosis*
Transplant Recipients
Transplants
Ultrasonography
Veins
Warfarin
Creatinine
Heparin
Warfarin

Figure

• 

  Fig. 1 Ultrasonography shows (A) filling defect (arrow) in main renal vein of allograft kidney and increased parenchyma echogenicity, and (B) absent venous blood flow (resistive index [RI]=0.75). Abbreviations: PSV, peak systolic velocity; EDV, end diastolic velocity; MDV, mean diastolic velocity.

• 

  Fig. 2 Magnetic resonance imaging shows thrombosis from allograft kidney vein to anastomosis site on (A) T1 image and (B) T2 image (arrow, respectively).

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