자발성 이식신 파열의 성공적 처치 1예 보고

Abstract

We report a case of spontaneous renal allograft rupture, was successfully managed by immediate graft exploration, evacuation of hematoma and suture of rupture site. Two courses of methylprednisolone pulse therapy were given at 1 and 2 week after renal transplantation with the diagnosis of acute rejection, which was confirmed by percutaneous allograft biopsy. On the 23rd post transplantation day, there was a sudden pain and tenderness on graft site with marked swelling. Abdominal ultrasonogram revealed collection of large amount of recent hematoma around the upper pole of the graft. Immediate graft exploration disclosed 300cc of hematoma and a rupture of the parenchyma(7cm x 1.5cm x 1 cm) on the upper portion of the convex border of the graft. Hemos-tasis was obtained by ligation of bleeding points and chromic cat-gat suture. The graft exploration and hemostasis were followed by immediate diuresis and gradual recovery of graft function. Thereafter the graft function returned to normal and has remained stable, with serum creatinine value of 1.5~2.0 mg/dl at two year after allograft rupture.