Chia-Wei Cheng, Kuan- Xun Huang, Wen-Horng Yang

鄭嘉緯、黃冠勳、楊文宏

Department of Urology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University

國立成功大學醫學院附設醫院泌尿部

 

Deep vein thrombosis (DVT) was a disease of multiple cause, such as inherited or acquired thrombophilia which were surgery, malignancy, prolonged bed rest, pregnancy or oral contraceptives related. The prevalence of DVT after kidney transplantation is rare but increased. As to the ipsilateral kidney autotransplantation, monitoring and dectection got more crucial. A 77-year-old gentleman with the history of bladder urothelial carcinoma history and left ureteral urothelial carcinoma, pT3, high grade s/p autotransplantation, partial cystectomy and ureterectomy. Left lower limb swelling without pitting edema and erythematous change was mentioned at the 10^th days after major operation. Left lower extremity sonography showed thrombosis. Pelvic MRI revealed extensive deep vein thrombosis from left common iliac vein, external iliac vein to femoral vein and extends into the renal vein of autotransplanted left kidney. Left iliac vein catheter base embolectomy was performed. Urokinase with heparin were kept infused by multisided-hole catheter into left external iliac vein. Three days later, angiography showed patent external iliac vein and renal function improved. Early PTA embolectomy was a feasible method for the treatment of DVT after kidney autotransplantation.