Background: Torsion of kidney transplant refers to rotation of the kidney transplant graft around its vascular pedicle resulting in vascular compromise and infarction. It is a rare complication of kidney transplantation associated with a high rate of graft loss. Clinical presentation and diagnostic imaging modalities are non-specific, and surgical exploration is therefore often delayed.
Methods: We present a case report and review of the literature. Studies were identified by searching Medline and Embase from January 1954 to December 2010. Data was extracted regarding the clinical presentation, investigation, findings on surgical exploration, and treatment outcomes of patients with torsion of kidney transplant.
Results: Eight manuscripts with 16 cases of kidney torsion were found. Presenting symptoms were decreased renal function (13 cases), abdominal pain (10 cases), oliguria/anuria (9 cases), nausea and vomiting (4 cases), fever (3 cases), diarrhoea (3 cases), weight gain (2 cases), oedema (3 cases), fatigue (1 case) and impalpable graft (1 case). Investigations were Doppler sonography (11 cases), grey-scale sonography (7 cases), nuclear scintigraphy (5 cases), computed tomography scan (4 cases), and magnetic resonance imaging/magnetic resonance angiography (1 case). Of the 16 published cases of torsion, seven (44%) grafts were detorted and salvaged, three (19%) grafts were detorted but subsequently lost and six (38%) patients underwent immediate nephrectomy.
Conclusions: A prompt consideration of the diagnosis of torsion of kidney transplant is required to prevent delay in surgical intervention. We recommend urgent Doppler ultrasound be used as first-line investigation, followed by prompt surgical exploration. We recommend the use of prophylactic nephropexy to prevent torsion.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1111/j.1445-2197.2011.05792.x | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Efficacy and safety of teriparatide in kidney transplant recipients with osteoporosis and low bone turnover: a real-world experience.
Int Urol Nephrol
January 2025
Nephrology, Dialysis and Kidney Transplant Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.
Introduction: Kidney transplantation is the preferred treatment for end-stage kidney disease (ESKD), enhancing survival and quality of life. However, kidney transplant recipients (KTRs) are at high risk for bone disorders, particularly low bone turnover disease, which increases fracture risk. Teriparatide, an anabolic agent, may provide a beneficial treatment option for these patients.
View Article and Find Full Text PDFStem cells prevent long-term deterioration of renal function after renal artery revascularization in a renovascular hypertension model in rats.
Sci Rep
January 2025
Renal Division, Department of Medicine, Universidade Federal de São Paulo, Rua Pedro de Toledo, 781, São Paulo, SP, 04039-032, Brazil.
Partial stenosis of the renal artery causes renovascular hypertension (RVH) and is accompanied by chronic renal ischemia, resulting in irreversible kidney damage. Revascularization constitutes the most efficient therapy for normalizing blood pressure (BP) and has significant benefits for renal function; however, the tissue damage caused by chronic hypoxia is not fully reversed. Mesenchymal stem cells (MSCs) have produced discrete results in minimizing RVH and renal tissue and functional improvements since the obstruction persists.
View Article and Find Full Text PDFThe Autonomic Nervous System and Inflammation in Chronic Kidney Disease.
Nephrol Dial Transplant
January 2025
Clinica Medica, University Milano-Bicocca and University of Milano-Bicocca, Milan, Italy.
The autonomic nervous system plays a crucial role in regulating physiological processes and maintaining homeostasis through its two branches: the sympathetic nervous system (SNS) and the parasympathetic nervous system. Dysregulation of the autonomic system, characterized by increased sympathetic activity and reduced parasympathetic tone, is a common feature in chronic kidney disease (CKD) and cardiovascular disease. This imbalance contributes to a pro-inflammatory state, exacerbating disease progression and increasing the risk for cardiovascular events.
View Article and Find Full Text PDFLow birth weight and chronic kidney disease with progression to kidney failure in children.
Nephrol Dial Transplant
January 2025
Institute of Population Health Sciences, National Health Research Institutes, Miaoli County, Taiwan.
Background And Hypothesis: It is unclear if low birth weight (LBW), preterm birth and small for gestational age (SGA) could synergistically cause chronic kidney disease (CKD) and end-stage kidney disease (ESKD). This cohort study was conducted to examine their individual and combined impacts on the development of CKD and ESKD in childhood.
Methods: From the Taiwan Maternal and Child Health Database, we identified 1 477 128 newborns born between January 1, 2009, and December 31, 2016.
Development and Internal Validation of a Novel Nomogram to Predict the Risk of Postoperative Acute Kidney Injury Following Robot-Assisted Partial Nephrectomy.
Urology
January 2025
Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH. Electronic address:
Objectives: To develop a predictive tool to assist in predicting the risk of Acute Kidney Injury (AKI) following robot-assisted partial nephrectomy (RAPN).
Methods: A retrospective review was performed on the prospectively maintained, IRB-approved database to identify all consecutive patients who underwent RAPN between 2008 and 2023. Patients with end-stage kidney disease (ESKD), horseshoe kidneys, solitary kidneys, and previous renal transplant recipients were excluded.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!