Management of vascular complications after kidney transplantation caused by donor derived infection: a report of 6 cases
10.3760/cma.j.cn421203-20210917-00233
- VernacularTitle:6例供者来源性感染致肾移植后血管并发症的诊疗经验
- Author:
Long ZHANG
1
;
Jiangqiao ZHOU
;
Tao QIU
;
Zhongbao CHEN
;
Jilin ZOU
;
Xiaoxiong MA
;
Zeya JIN
;
Yu XU
;
Xiuheng LIU
Author Information
1. 武汉大学人民医院器官移植科，武汉 430060
- Keywords:
Kidney transplantation;
Vascular complications after transplantation;
Infection
- From:
Chinese Journal of Organ Transplantation
2022;43(6):340-345
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To summarize the institutional experiences of treating vascular complications caused by donor-derived infection(DDI)after kidney transplantation(KT).Methods:From January 1, 2015 to December 31, 2020, clinical data were retrospectively reviewed for 6 cases of vascular complications caused by DDI.Age, gender, surgical approaches, immunity induction therapy, immune suppression therapy, infection prevention, onset time of complication, type of complications, infection pathogens, therapeutic protocols and prognoses were summarized.Results:Six patients developed vascular complications caused by DDI in 997 KT recipients with an overall morbidity rate of 0.6%.In 3 cases, carbapenem resistant Klebsiella pneumoniae were positive in culture of secretion and blood samples.And Candida albicans was detected by blood cultures and pathological examinations.One case of antibiotic resistant Staphylococcus aureus was detected by blood culture.Among 3 cases of transplant kidney artery pseudoaneurysm on interventional therapy, there were curing(1 case)and immediate recurrent infection(2 cases). The latter two eventually died by cardiac complications.In 2 cases of arterial hemorrhage, graft nephrectomy was followed by hemodialysis.One case of transplanted renal artery stenosis was successfully cured by artery stenting and survived with normal graft function so far.Conclusions:Interventional endovascular therapy and open surgery are indicated for vascular complications caused by DDI post-KT.Interventional therapy may boost the odds of rescuing transplant kidney.However, clinicians should watch out for the risk of recurrent infection.Open surgery is an effective tool of eliminating infected focus.Preserving transplant kidney or nephrectomy may be adopted on the basis of specific conditions.
