Renal transplantation is the treatment of choice for patients with chronic renal failure, which produces a dramatic improvement in the quality of life and survival rates, in comparison to long-term dialysis. Nowadays, new imaging modalities allow early diagnosis of complications, and thanks to the recent developments of interventional techniques, surgery may be avoided in most cases. Knowledge in the types of renal transplant complications is fundamental for a correct pre-operative planning. In this article, we described the most common or clinically relevant renal transplant complications and explained their interventional management.
Diagnostic Imaging ; Female ; Humans ; Kidney Failure, Chronic/*surgery ; Kidney Transplantation/*adverse effects ; Male ; Middle Aged ; Postoperative Complications/diagnosis/*radiography ; Quality of Life ; Survival Rate

No abstract available.
Adult ; Female ; Graft Rejection/immunology/*prevention & control ; Graft Survival ; *Hematopoietic Stem Cell Transplantation ; Humans ; *Immune Tolerance ; Immunosuppressive Agents/therapeutic use ; Kidney Failure, Chronic/diagnosis/*surgery ; *Kidney Transplantation ; Living Donors ; Siblings ; Time Factors ; *Transplantation Chimera ; Treatment Outcome

Ultrasound-guided cannulation of a large-bore catheter into the internal jugular vein was performed to provide temporary hemodialysis vascular access for uremia in a 65-yr-old woman with acute renal failure and sepsis superimposed on chronic renal failure. Despite the absence of any clinical evidence such as bleeding or hematoma during the procedure, a chest x-ray and computed tomographic angiogram of the neck showed that the catheter had inadvertently been inserted into the subclavian artery. Without immediately removing the catheter and applying manual external compression, the arterial misplacement of the hemodialysis catheter was successfully managed by open surgical repair. The present case suggests that attention needs to be paid to preventing iatrogenic arterial cannulation during central vein catheterization with a large-bore catheter and to the management of its potentially devastating complications, since central vein catheterization is frequently performed by nephrologists as a common clinical procedure to provide temporary hemodialysis vascular access.
Acidosis/complications ; Acute Disease ; Aged ; Catheterization, Central Venous/*adverse effects ; Female ; Hemorrhage/etiology ; Humans ; Kidney Failure, Chronic/*diagnosis ; Medical Errors/*prevention & control ; Oliguria/complications ; Renal Dialysis ; Sepsis/etiology ; Subclavian Artery/injuries/*radiography/surgery ; Tomography, X-Ray Computed ; Uremia/etiology

The aim of this study was to evaluate and compare the Child-Turcotte-Pugh (CTP) classification system and the model for end-stage liver disease (MELD) score in predicting the severity of the systemic inflammatory response in living-donor liver transplantation patients. Recipients of liver graft were allocated to a recipient group (n = 39) and healthy donors to a donor group (n = 42). The association between the CTP classification, the MELD scores and perioperative cytokine concentrations in the recipient group was evaluated. The pro-inflammatory cytokines measured included interleukin (IL)-1beta, IL-6, and tumor necrosis factor (TNF)-alpha; the anti-inflammatory cytokines measured included IL-10 and IL-4. Cytokine concentrations were quantified using sandwich enzyme-linked immunoassays. The IL-6, TNF-alpha, and IL-10 concentrations in the recipient group were significantly higher than those in healthy donor group patients. All preoperative cytokine levels, except IL-6, increased in relation to the severity of liver disease, as measured by the CTP classification. Additionally, all cytokine levels, except IL-6, were significantly correlated preoperatively with MELD scores. However, the correlations diminished during the intraoperative period. The CTP classification and the MELD score are equally reliable in predicting the severity of the systemic inflammatory response, but only during the preoperative period.
Adult ; Cytokines/*blood ; Female ; Humans ; Interleukin-10/blood ; Interleukin-1beta/blood ; Interleukin-4/blood ; Interleukin-6/blood ; Kidney Failure, Chronic/*classification/*surgery ; Liver/pathology ; *Liver Transplantation ; Living Donors ; Male ; Middle Aged ; Predictive Value of Tests ; Severity of Illness Index ; Systemic Inflammatory Response Syndrome/*diagnosis ; Treatment Outcome ; Tumor Necrosis Factor-alpha/blood