Deceased Donor Renal Transplantation Combined with Bilateral Nephrectomy in a Patient with Tuberous Sclerosis and Renal Failure. (6th March 2019)

• Record Type: Journal Article
• Authors: Novotny, R.; Chlupac, J.; Marada, T.; Bloudickova-Rajnochova, S.; Vavrinova, H.; Janousek, L.; Fronek, J.
• Other Names: Grenda Ryszard Academic Editor.
• Is Part Of: Case reports in transplantation. Volume 2019(2019)
• Publication Date: 2019-03-06
• Subjects: Transplantation of organs, tissues, etc -- Periodicals; Transplantation; Transplantation of organs, tissues, etc; Periodicals; Periodicals; 617.954
• DOI: 10.1155/2019/2172163
• Languages: English
• ISSNs: 2090-6943

Abstract

Abstract : Introduction . A 27-year-old female patient with known tuberous sclerosis complex (TSC), polycystic kidneys with multiple large bilateral angiomyolipomas, and failing renal functions with prehemodialysis values (urea: 19 mmol/L; creatinine: 317 μ mol/L; CKD-EPI 0, 27) was admitted to our department for pre-renal transplant evaluation. The patient was placed on the transplant waiting list as the living donor did not pass pretransplant workup and was subsequently contraindicated. Patient was placed on the "cadaverous kidney transplant waiting list". Method . Computed tomography angiography revealed symptomatic PSA in the right kidney angiomyolipoma (AML). The patient underwent urgent transarterial embolisation of the PSA's feeding vessel in the right kidney AML. Based on the "kidney transplant waiting list" order patient underwent a bilateral nephrectomy combined with transperitoneal renal allotransplantation of a cadaverous kidney graft through midline laparotomy, appendectomy, and cholecystectomy. Results . Postoperative period was complicated by delayed graft function caused by acute tubular necrosis requiring postoperative hemodialysis. The patient was discharged on the 17th postoperative day with a good renal graft function. Patient's follow-up is currently 23 months with good graft function (urea: 9 mmol/L; creatinine: 100 μ mol/L). Conclusion . Renal transplantation combined with radical nephrectomy provides a definitive treatment for TSC renal manifestations.