Work

Liquefaction of renal allograft: An unprecedented complication in transplantation medicine

Year: 2025

Type: article

Abstract: Background: Renal transplantation stands as the gold standard treatment for end-stage renal disease, offering improved quality of life and increased survival compared to dialysis. However, despite its advantages, renal allograft failure can occur, necessitating careful management to mitigate associated complications. Instances of liquefaction of the transplanted kidney are exceedingly rare, posing unique challenges to clinicians in the management of allograft failure. Existing literature highlights the complexities surrounding decisions regarding dialysis reinitiation, immunosuppression management, and the potential need for transplant nephrectomy in patients with failed renal allografts. Case presentation: A 52-year-old Caucasian female with a complex medical history including stage 5 chronic kidney disease, non-ST-segment elevation myocardial infarction, hypertrophic cardiomyopathy with mild left ventricular systolic dysfunction, atrial fibrillation, and a history of cardiac arrest resulting in hypoxic brain injury, presented with a unique complication following renal transplantation. Imaging studies revealed complete breakdown and liquefaction of the transplanted kidney in the right iliac fossa. Despite interventions such as ultrasound-guided aspiration and drainage, the patient's condition continued to deteriorate. Conclusion: This case highlights a rare occurrence of allograft liquefaction following renal transplantation, emphasising the need for vigilance in monitoring transplant recipients for uncommon complications. The management of such cases requires a multidisciplinary approach, considering factors such as dialysis reinitiation timing, immunosuppression management, and the potential need for transplant nephrectomy. Further research is warranted to elucidate the pathophysiology and optimal management strategies for unique complications such as allograft liquefaction, underscoring the importance of individualised treatment approaches in complex clinical scenarios.

Source: Ultrasound

DOI: 10.1177/1742271x251337256

Authors: Salman J Arain, Adam H Morrell

Institutions: Leeds Teaching Hospitals NHS Trust, University of Leeds

Language: English

Topic: Renal Transplantation Outcomes and Treatments

Subfield: Transplantation

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: hybrid

Estimated APC paid: $4,150