Skip to main content
Log in

Infective Artery Rupture of Renal Allografts: A Single-Center Retrospective Study in China

  • Published:
Current Medical Science Aims and scope Submit manuscript

Abstract

Objective

This study investigated the composition of pathogenic microorganisms, clinical features, and therapeutic strategies of infective artery rupture of renal allografts in recipients receiving deceased donor (DD) kidneys.

Methods

We retrospectively studied the clinical data of the DD kidney transplant recipients with donor-associated infection at Tongji Hospital, Wuhan, China from January 1, 2015 to December 31, 2018, related recipients and corresponding donors. We collected the entire results of pathogenic microorganisms cultured from these related ruptured kidneys and then analyzed their distribution and differences.

Results

A total of 1440 kidney transplants from DD were performed in our center. The total incidence of infective artery rupture in kidney transplants was about 0.76% (11/1440), and the annual incidence ranged from 0.25% to 1.03%. The microbial culture results revealed that 11 recipients suffered from infective artery rupture and 3 recipients who accepted the kidney from same donor had the donor-associated pathogens, including 9 fungal strains (28.1%) and 23 bacterial strains (71.9%). There were 4 recipients infected with multi-drug-resistant Staphylococcus and Klebsiella pneumoniae from the above 11 recipients, of which, 10 recipients underwent graft loss, and one died of septic shock. The microbial cultures of the remaining 3 recipients who received appropriate anti-infective regimens turned negative eventually, and the patients were discharged successfully without significant complications.

Conclusion

Renal recipients with infections derived from DDs were at high risk of artery rupture, graft loss, or even death. Appropriate anti-infective treatment is essential to reduce the incidence of artery rupture and mortality.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Oktar T, Koçak T, Tefik T, et al. An updated analysis of the surgical and urological complications of 789 living-related donor kidney transplantations: Experience of a single center. Ulus Travma Acil Cerrahi Derg, 2020, 26(2):197–202

    PubMed  Google Scholar 

  2. Asztalos L, Olvasztó S, Fedor R, et al. Renal artery aneurysm at the anastomosis after kidney transplantation. Transplant Proc, 2006,38(9):2915–2918

    Article  CAS  Google Scholar 

  3. Calviño J, Romero R, Pintos E, et al. Renal artery rupture secondary to pretransplantation Candida contamination of the graft in two different recipients. Am J Kidney Dis, 1999,33(1):E3

    Article  Google Scholar 

  4. Kaabak M, Babenko N, Zokoev A, et al. Successful repair of kidney graft artery rupture using external stenting. Transplantation, 2013,95(7):e48–49

    Article  Google Scholar 

  5. Pappas PG, Alexander BD, Andes DR, et al. Invasive fungal infections among organ transplant recipients: results of the Transplant-Associated Infection Surveillance Network (TRANSNET). Clin Infect Dis, 2010,50(8):1101–1111

    Article  Google Scholar 

  6. Ye QF, Zhou W, Wan QQ. Donor-derived infections among Chinese donation after cardiac death liver recipients. World J Gastroenterol, 2017,23(31):5809–5816

    Article  Google Scholar 

  7. Lewis JD, Sifri CD. Multidrug-Resistant Bacterial Donor-Derived Infections in Solid Organ Transplantation. Curr Infect Dis Rep, 2016,18(6):18

    Article  Google Scholar 

  8. Vaccarisi S, Bonaiuto E, Spadafora N, et al. Complications and graft survival in kidney transplants with vascular variants: our experience and literature review. Transplant Proc, 2013,45(7):2663–2665

    Article  CAS  Google Scholar 

  9. Wang Y, Lei H, Zhang Y, et al. Epidemiology of carbapenem-resistant Klebsiella pneumoniae bloodstream infections after renal transplantation from donation after cardiac death in a Chinese hospital: a case series analysis. Antimicrob Resist Infect Control, 2018,7:66

    Article  Google Scholar 

  10. Laouad I, Buchler M, Noel C, et al. Renal artery aneurysm secondary to Candida albicans in four kidney allograft recipients. Transplant Proc, 2005,37(6):2834–2836

    Article  CAS  Google Scholar 

  11. Polat KY, Aydinli B, Keles M, et al. Spontaneous mycotic external iliac artery aneurysm rupture after perforated acute appendicitis in a renal allograft recipient. Exp Clin Transplant, 2011,9(3):211–213

    PubMed  Google Scholar 

  12. Barlas A, Moris D, Bokos J, et al. A forgotten vascular technique in renal transplantation. Vasc Endovascular Surg, 2014,48(3):281–282

    Article  Google Scholar 

  13. Adani GL, Baccarani U. The use of iliac Y-graft for arterial revascularization in simultaneous double-kidney transplantation. Transplantation, 2012,93(12):e46–48

    Article  Google Scholar 

  14. Ezzatzadegan S, Chen S, Chapman JR. Invasive fungal infections after renal transplantation. Int J Organ Transplant Med, 2012,3(1):18–25

    CAS  PubMed  PubMed Central  Google Scholar 

  15. Guimarães LF, Halpern M, de Lemos AS, et al. Invasive Fungal Disease in Renal Transplant Recipients at a Brazilian Center: Local Epidemiology Matters. Transplant Proc, 2016,48(7):2306–2309

    Article  Google Scholar 

  16. Matignon M, Botterel F, Audard V, et al. Outcome of renal transplantation in eight patients with Candida sp. contamination of preservation fluid. Am J Transplant, 2008,8(3):697–700

    Article  CAS  Google Scholar 

  17. Zhan HX, Lv Y, Zhang Y, et al. Hepatic and renal artery rupture due to Aspergillus and Mucor mixed infection after combined liver and kidney transplantation: a case report. Transplant Proc, 2008,40(5):1771–1773

    Article  CAS  Google Scholar 

  18. Gavaldà J, Meije Y, Fortún J, et al. Invasive fungal infections in solid organ transplant recipients. Clin Microbiol Infect, 2014,20 Suppl 7:27–48

    Article  Google Scholar 

  19. Schmiedel Y, Zimmerli S. Common invasive fungal diseases: an overview of invasive candidiasis, aspergillosis, cryptococcosis, and Pneumocystis pneumonia. Swiss Med Wkly, 2016,146:w14281

    PubMed  Google Scholar 

  20. Wang R, Wu J, Wang Y, et al. Aspergillus infection limited to the anastomosed artery following renal transplantation: a report of 4 cases. Transpl Infect Dis, 2009,11(4):363–366

    Article  CAS  Google Scholar 

  21. Zhu X, Liu H, Wang W, et al. Two cases of transplant renal artery thrombosis and spontaneous rupture caused by mucormycosis. Transpl Infect Dis, 2015,17(3):442–448

    Article  CAS  Google Scholar 

  22. Husain S, Tollemar J, Dominguez EA, et al. Changes in the spectrum and risk factors for invasive candidiasis in liver transplant recipients: prospective, multicenter, case-controlled study. Transplantation, 2003,75(12):2023–2029

    Article  Google Scholar 

  23. Mai H, Champion L, Ouali N, et al. Candida albicans arteritis transmitted by conservative liquid after renal transplantation: a report of four cases and review of the literature. Transplantation, 2006,82(9):1163–1167

    Article  Google Scholar 

  24. Gomez CA, Singh N. Donor-derived filamentous fungal infections in solid organ transplant recipients. Curr Opin Infect Dis, 2013,26(4):309–316

    Article  Google Scholar 

  25. Tang M, Xu X, Shen B, et al. Fifty-one cases of fungal arteritis after kidney transplantation: A case report and review of the literature. Transpl Infect Dis, 2017,19(6):e12781

    Article  Google Scholar 

  26. Usman R, Jamil M, Safdar A, et al. Successful Repair of a Pseudoaneurysm of Renal Allograft Artery. J Coll Physicians Surg Pak, 2015,25 Suppl 2:S142–144

    PubMed  Google Scholar 

  27. Liu G, Wang X, Wu J, et al. Successful repair of kidney graft artery rupture secondary to infection using a preprocessed homologous “Y”-shaped iliac artery. Clin Transplant, 2019,33(4):e13493

    Article  Google Scholar 

  28. Caño-Velasco J, Polanco-Pujol L, González-García J, et al. Renal artery infectious (mycotic) pseudoaneurysms in renal transplantation recipients. Actas Urol Esp (Engl Ed), 2021,45(5):335–344

    Article  Google Scholar 

  29. Che HJ, Song FB, Li XY, et al. Retrospective evaluation of the endovascular repair of the anastomotic pseudoaneurysm of the transplanted renal artery using the snorkel technique. Vascular, 2020,28(4):475–480

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Sheng Chang.

Ethics declarations

The authors have no conflicts of interest to declare.

Author Zhi-shui CHEN is a member of the Editorial Board for Current Medical Science. The paper was handled by other editors and has undergone rigorous peer review process. Author Zhi-shui CHEN was not involved in the journal’s review of, or decision related to, this manuscript.

Additional information

This project was supported by the Natural Science Foundation of China (No. 81873511 and No. 81471587).

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Guo, Yl., Lu, X., Zhu, L. et al. Infective Artery Rupture of Renal Allografts: A Single-Center Retrospective Study in China. CURR MED SCI 42, 847–855 (2022). https://doi.org/10.1007/s11596-022-2557-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11596-022-2557-9

Key words

Navigation