TN11RENAL ALLOGRAFT COMPRESSION SYNDROME: A REAL ENTITY

Renal allograft compression syndrome (RACS) is being increasingly recognised as cause of early allograft dysfunction. To assess the validity of RACS. Clinical and laboratory findings used to diagnose RACS included acute allograft dysfunction (+ oliguria), duplex ultrasound demonstrating diminished, or reversed diastolic flow within interlobar and segmental arteries and, biopsy showing absence of acute rejection or toxicity. Final diagnosis was made at urgent laparotomy. Observations of poor allograft colour and perfusion after reopening the retroperitoneum were considered confirmatory for RACS. Series includes 2 males and 1 female patients. Time elapsed between transplantation and RACS diagnosis was 24-48 hrs. After surgical decompression the allograft perfusion improved visibly in two patients and these cases were then closed with PTFE mesh hood closure. There was no significant improvement observed in the third case that had a renal vein thrombus, which ultimately led to the demise of the graft. Beneficial clinical results were obtained in two cases documented by a sustained decrease in creatinine. Average follow-up was 9.5 months without any allograft dysfunction. RACS is a real entity with a potential to cause graft loss. Kidney can be salvaged by urgent surgical decompression and PTFE mesh closure. [PUBLICATION ABSTRACT]