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Year : 2014  |  Volume : 8  |  Issue : 2  |  Page : 57-59

Successful thrombolysis of renal allograft venous thrombosis – A case report

1 Department of Nephrology, Meenakshi Mission Hospital, Madurai, Tamil Nadu 625002, India
2 Department of Radiology, Meenakshi Mission Hospital, Madurai, Tamil Nadu 625002, India

Correspondence Address:
Sampath Kumar Krishnaswamy
Department of Nephrology, Meenakshi Mission Hospital, Madurai, Tamil Nadu 625002
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Source of Support: None, Conflict of Interest: None

DOI: 10.1016/j.ijt.2014.05.003

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Renal allograft venous thrombosis is a rare but catastrophic complication resulting in graft failure. A 55-year-old male underwent live related renal transplantation. Donor's right kidney was placed in recipient's left iliac fossa. Graft renal artery was anastomosed to the left internal iliac artery. Graft renal vein was anastomosed to the left external iliac vein in a side to side fashion. He was discharged with a serum creatinine of 0.9 mg. Four weeks after transplantation patient was readmitted with anuria for 6 h and swelling of left leg for 1 day. Doppler study showed extensive venous thrombosis extending from left femoral, external iliac veins with total occlusion of allograft vein. Renal arterial diastolic flow was absent. Blood urea was 36 mg/dl and creatinine was 2.2 mg/dl. A fogarty's catheter was inserted in the popliteal vein and venogram was performed to outline the extent of thrombus. Thrombosuction followed by In situ thrombolysis with streptokinase and heparin were carried out. His renal parameters and urine output dramatically improved following our intervention. He was discharged with the creatinine of 0.8 mg/dl. Salvage of the allograft in renal vein thrombosis is possible if early diagnosis and aggressive thrombolytic therapy are instituted.

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