Cost of a delay. Issue 4 (20th April 2019)

• Record Type: Journal Article
• Authors: Pradhan, Aditya; Singh Rana, Yajvender Pratap; Sinha, Harish K; Goel, Sunny
• Is Part Of: BMJ case reports. Volume 12:Issue 4(2019)
• Publication Date: 2019-04-20
• Subjects: hypertension -- renal system -- transplantation; Medicine -- Case studies -- Periodicals; 610.5
• DOI: 10.1136/bcr-2018-228667
• Languages: English
• ISSNs: 1757-790X

Abstract

Abstract : Abandoning a renal transplant operation during a live-related transplant is a rare occurrence. We recently encountered a case of previously undiagnosed coarctation of aorta (CoA) in the recipient during surgery. This was diagnosed by the absence of femoral pulses, a Doppler scan showing monophasic flows bilaterally in the iliac arteries and a difference in the mean arterial pressure between the radial artery and iliac artery of 50 mm Hg. The donor and recipient surgery were abandoned. A CT aortogram was done on the recipient which showed a tight CoA. An angioplasty was performed and a bare metal stent placed for correction of CoA. After a week, transplantation was performed, and the patient made an uneventful recovery. This case highlights the importance of assessment of the peripheral pulses and noting a radiofemoral delay, which was missed in the preoperative assessment.