RESUMO
OBJECTIVES: The renal graft rupture (RGR) was first described in 1968; it is a severe situation, generally appearing in the immediate post-operative period. OBJECTIVES: To retrospectively analyze the incidence of renal graft rupture in the population of patients who underwent kidney transplant in the Renal Transplant Department of the Angerich Hospital. METHODS: 492 kidney transplants were performed from 1-1-1992 to 7-31-2005. 422 (85.7%) cadaver donor transplants and 70 (14.3%) live related donor transplants. RESULTS: 11 renal ruptures were observed, with a clinical picture characterized by sudden pain in the graft area, hypotension, and hematocrit descent. CT scan confirmed the diagnosis. Seven patients underwent transplant nephrectomy (one of them 24 hours after surgical repair), another two were surgically repaired successfully, and for the other two patients a conservative management with watchful waiting also resulted in graft preservation. All cases where cadaver donor drafts. CONCLUSIONS: 1) The renal graft rupture is a rare (2.8% in our series) severe complication characterized by hemodynamic instability, with no diagnostic doubts about its presentation in most cases. We use ultrasound as the diagnostic test. 2) In our series we were able to preserve 40% of the kidneys with low morbidity. 3) This complication appeared in cadaver donor kidneys in all cases (11/386; 2.8%).
Assuntos
Transplante de Rim , Complicações Pós-Operatórias , Adolescente , Adulto , Feminino , Humanos , Incidência , Masculino , Complicações Pós-Operatórias/epidemiologia , Estudos Retrospectivos , RupturaRESUMO
Nephroblastoma or Wilms tumor is the most common renal neoplasia in children, representing 1/5 of the malignant tumors in this group. Nevertheless, the incidence of such tumor in adults is much rarer with less than 250 cases reported. Due to the low-frequency of this pathology in adults there is not a world widely accepted treatment modality. Currently, the therapeutic options derive from the National Wilms Tumor Study (NWTS). We report a new case with the radiological images, histologic findings, outcomes and follow-up.