Summary
Spontaneous rupture of allografted kidneys occurred in 6 cases after 95 renal transplantations performed in the Department of General Surgery at the University Clinic in Essen. An analysis of this complication after renal transplantation is presented considering our own experience and 60 cases from the literature. The characteristic symptoms which were found in all cases consisted of oliguria, pain and swelling of the graft site and signs of hemorrhage. In 90 % transplant rupture occurred within 3 weeks postoperatively. The surgical therapy should preserve the ruptured organ whenever possible. In 5 of our 6 cases we were successful in preserving the graft by suturing the tear. The analysis of the etiologic factors of 66 cases shows that oedema of the renal graft is the most common finding. A possible etiological factor seems to be the method of organ preservation.
Zusammenfassung
Nach 95 Nierentransplantationen wurde im Krankengut der Chirurgischen Universitätsklinik Essen 6mal eine Transplantatruptur beobachtet. Anhand dieser Erfahrungen und der Auswertung von 60 Kasuistiken aus dem Schrifttum erfolgt eine Analyse dieser Komplikation nach Nierentransplantation. In allen Fällen wurde eine charakteristische Symptomatik festgestellt, die in Oligurie, Schmerzen und Schwellung im Transplantatbereich sowie Zeichen der inneren Blutung bestand. Gemeinsam war weiterhin, daß 90% der Transplantatrupturen sich innerhalb der ersten 3 postoperativen Wochen ereigneten. Die Organerhaltung wird angestrebt, im eigenen Krankengut konnte 5 mal erfolgreich eine Blutstillung durch Übernähung der Ruptur erreicht werden. Anhand von insgesamt 66 Kasuistiken werden die ätiologischen Faktoren untersucht. Dabei zeigt sich die Organschwellung als den meisten Rupturereignissen gemeinsamer Befund. Eine kausale Bedeutung scheint möglicherweise dem Konservierungsverfahren zuzukommen.
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Dostal, G., Medrano, J. & Eigler, F.W. Die spontane Nierentransplantatruptur spontaneous rupture of the allografted kidney. Langenbecks Arch Chiv 341, 87–98 (1976). https://doi.org/10.1007/BF01262780
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DOI: https://doi.org/10.1007/BF01262780