Trauma to transplanted kidney with open fractures: Report of a case

• Authors: Turgut Piskin , Cemalettin Aydin , Cuneyt Kayaalp , Fatih Sumer
• Languages of publication: EN

Abstracts

EN

A 45 year-old man, who had undergone kidney transplantation 7 years prior, was admitted to hospital after a motorcycle accident. The patient was conscious, hemodynamically stable, and had suffered open tibia and femur fractures, as well as closed pubic arm fractures. He had gross hematuria and radiologic study revealed a 3.5 cm length laceration on the transplanted kidney. His renal functions and hematuria recovered after intensive care. He required 2 surgeries for the open fractures but his general condition worsened after the surgical interventions. Acinetobacter, Candida albicans and pseudomonas aeruginosa were determined by blood cultures. Immunosupressive drugs (cyclosporine, prednisolone and azathioprine) were stopped. Despite intensive care, the patient died of sepsis 17 days post trauma. Open fractures of long bones provide a higher risk of sepsis in transplant patients than closed fractures.

Keywords

EN

Kidney transplantation; Trauma; Open fracture

• Publisher: De Gruyter Open
• Journal: Open Medicine
• Year: 2010
• Volume: 5
• Issue: 6
• Pages: 716-718

Dates

published

1 - 12 - 2010

online

7 - 10 - 2010

Contributors

author

Turgut Piskin

• Turgut Ozal Medical Center, Department of General Surgery, Inonu University, 44315, Malatya, Turkey

author

Cemalettin Aydin

• Turgut Ozal Medical Center, Department of General Surgery, Inonu University, 44315, Malatya, Turkey

author

Cuneyt Kayaalp

• Turgut Ozal Medical Center, Department of General Surgery, Inonu University, 44315, Malatya, Turkey

author

Fatih Sumer

• Turgut Ozal Medical Center, Department of General Surgery, Inonu University, 44315, Malatya, Turkey

References

• [1] Neipp M, Karavul B, Jackobs S, Meyer zu Vilsendorf A, Richter N, Becker T, Schwarz A, Klempnauer J. Quality of life in adult transplant recipients more than 15 years after kidney transplantation. Transplantation. 2006:27;81:1640–1644 http://dx.doi.org/10.1097/01.tp.0000226070.74443.fb
• [2] Selman SH, Grecos GP, Koo BC. Anuria in transplant patient following inguinal herniorrhaphy. J Urol. 1985;133:669–670
• [3] Shrestha BM, Throssell D, McKane W, Raftery AT. Injury to a transplanted kidney during caesarean section: a case report. Exp Clin Transplant. 2007;5:618–620 [PubMed]
• [4] Kobayashi S, Monma T, Adachi W, Nakata S, Yamaura K, Amano J, Iizuka K, Nishizawa O, Kaneko G. Urinary bladder injury during inguinal herniorrhaphy in a renal transplant patient: report of a case. Surg Today. 2000;30:101–103 http://dx.doi.org/10.1007/PL00010037[Crossref]
• [5] McHugh PP, Clifford TM, Johnston TD, Banerjee AS, Gedaly R, Jeon H, Ranjan D. Seatbelt injury resulting in functional loss of a transplanted kidney. Prog Transplant. 2008;18:199–202 [PubMed]
• [6] Urquhart CK, Hawkins ML, Wynn JJ, Humprhies AL, Mansberger AR. Management of the injured renal transplant patient. South Med J. 1991;84:524–526 http://dx.doi.org/10.1097/00007611-199104000-00033[Crossref]
• [7] Martinez-Mier G, García-Almazan E, Esselente-Zetina N, Tlatelpa-Mastranso MA, Mendez-Lopez MT, Estrada-Oros J. Blunt trauma in kidney transplant with preservation of renal function. Cir Cir. 2006;74:205–208
• [8] Barone GW, Sailors DM, Hudec WA, Ketel BL. Trauma management in solid organ transplant recipients. J Emerg Med. 1997;15:169–176 http://dx.doi.org/10.1016/S0736-4679(96)00315-0[Crossref]
• [9] Mohammed EP, Venkat-Raman G, Marley N. Is trauma associated with acute rejection of a renal transplant? Nephrol Dial Transplant. 2002;17:283–284 http://dx.doi.org/10.1093/ndt/17.2.283[Crossref]
• [10] Braga Junior JW, Neves RM, Pinheiro MM, Frisoli Junior A, Castro CH, Szejnfeld VL, Carvalho AB. Prevalence of low trauma fractures in long-term kidney transplant patients with preserved renal function. Braz J Med Biol Res. 2006;39:137–147 http://dx.doi.org/10.1590/S0100-879X2006000100016[Crossref]
• [11] Epstein S, Shane E, Bilezikian JP. Organ transplantation and osteoporosis. Curr Opin Rheumatol. 1995;7:255–261 http://dx.doi.org/10.1097/00002281-199505000-00018[Crossref]
• [12] Meys E, Fontanges E, Fourcad N, Thomasson A, Pouyet M, Delmas PD. Bone loss after orthotopic liver transplantation. Am J Med. 1994;97:445–450 http://dx.doi.org/10.1016/0002-9343(94)90324-7[Crossref]
• [13] Hay JE. Bone disease in liver transplant recipients. Gastroenterol Clin North Am. 1993;22:337–349 [PubMed]
• [14] Shane E, Rivas MC, Silverberg SL, Kim TS, Staron RB, Bilezikian JP. Osteoporosis after cardiac transplantation. Am J Med. 1993;94:257–264 http://dx.doi.org/10.1016/0002-9343(93)90057-V[Crossref]
• [15] Rosenthal RE, Johnson HK, Richie RE. Massive skeletal trauma in renal transplant patients. South Med J. 1976;69:1582–1584 [PubMed]

Identifiers

DOI

10.2478/s11536-009-0134-2