Delayed Graft Function Is Associated with Microvascular Thrombosis in a Donor with Disseminated Intravascular Coagulation.
10.4285/jkstn.2016.30.1.31
- Author:
Yun Ju CHO
1
;
Jee Wan WEE
;
Soon Hyo KWON
;
Jin Seok JEON
;
Hyunjin NOH
;
Dong Cheol HAN
;
Dan SONG
;
So Young JIN
Author Information
1. Department of Internal Medicine, Soonchunhyang University College of Medicine, Seoul, Korea. jeonjs@shcmc.ac.kr
- Publication Type:Case Report
- Keywords:
Delayed graft function;
Disseminated intravascular coagulation;
Thrombosis
- MeSH:
Adult;
Allografts;
Biopsy;
Brain Injuries;
Cardiopulmonary Resuscitation;
Dacarbazine;
Delayed Graft Function*;
Disseminated Intravascular Coagulation*;
Extracorporeal Membrane Oxygenation;
Female;
Fibrin;
Follow-Up Studies;
Hemodynamics;
Humans;
Kidney;
Kidney Failure, Chronic;
Male;
Renal Dialysis;
Subarachnoid Hemorrhage;
Thrombosis*;
Tissue Donors*;
Transplants
- From:The Journal of the Korean Society for Transplantation
2016;30(1):31-34
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Microvascular thrombosis is an uncommon pathological finding in deceased donor kidneys. It is associated with disseminated intravascular coagulation (DIC) after brain injury in the donor. Although DIC in deceased kidney donors is known to have no association with graft outcome, microvascular thrombosis with DIC in a donor can cause renal graft impairment. For this reason, some transplantation centers do not accept these kidneys. A 39-year-old female donor had a subarachnoid hemorrhage. After a short period of cardiopulmonary resuscitation, we applied extracorporeal membrane oxygenation to maintain hemodynamic stability. The laboratory data were consistent with DIC. The recipient was a 38-year-old male patient who had been undergoing hemodialysis for 7 years because of end-stage renal disease of unknown cause. Zero-time graft biopsy revealed multiple intraluminal fibrin thrombi without peritubular capillaritis. Delayed graft function occurred after transplantation, and hemodialysis was started. Graft renal biopsy was performed on the third day after transplantation. The percentage of intraglomerular fibrin thrombi had decreased, and no significant peritubular capillaritis or C4d staining was observed. The function of the transplanted kidney started to recover, and hemodialysis was discontinued on the 10th day after surgery without specific treatment. Follow-up biopsy performed 20 days after the transplantation revealed normal kidney with completely resolved fibrin thrombi. We report herein a case of microvascular thrombosis in renal allograft from a DIC donor.
