移植腎血管之假性動脈瘤及動脈破裂成功修補案例報告
林佑樺, 姜秉均, 廖俊厚
天主教耕莘醫療財團法人耕莘醫院 外科部 泌尿科
Successful repair of renal arterial rupture and arterial pseudoaneurysm in graft kidneys from the same deceased donor
Yu-Hua Lin, Bing-Juin Chiang, Chun-Hou Liao
Division of Surgery, Department of Urology, Cardinal Tien Hospital, New Taipei City, Taiwan, R.O.C.
Purpose:
We demonstrate two rare cases of pseudoaneurysm and arterial rupture over the anastomosis site after renal transplant from the same deceased donor. We also reviewed all similar cases during the past 50 years and compare their management and outcome while encountered during the competition.
Vascular complications represent serious problems after kidney transplantation. An aneurysm or rupture of the graft artery is a tremendously rare but potentially devastating complication, which may lead to renal function impairment, graft loss, or even death. Here we present two rare vascular complications in early post-operative course after renal transplantation from the same deceased donor.
A 49-year-old woman suffered from spontaneous graft arterial rupture 13 days after kidney transplantation presented with suddenly distended right lower abdomen; another 56-year-old female recipient had graft renal arterial pseudoaneurysm presenting with decreased urine output and deteriorated renal function 32 days after transplantation. Immediate surgical repair with simultaneous cooling of the graft was performed, and TISSEEL® was applied for strengthening the fragile renal arterial wall.
In comparison to poor prognosis of graft kidneys in previous reports, renal function recovered well in both patients. Surgical reconstruction of a renal artery and with resection of aneurysm, if feasible, is a safe procedure that prevents aneurysm rupture and saves the graft.