Anesth Pain Med.  2015 Oct;10(4):301-307. 10.17085/apm.2015.10.4.301.

Severe and persistent hypotension after simultaneous nephrectomy and kidney transplantation in patients with chronic renal failure caused by polycystic kidney disease: Two cases report

• Hong SH
• Huh JW
• Lee J

• KMID: 2148018
• DOI: http://doi.org/10.17085/apm.2015.10.4.301

Abstract

Patients with autosomal dominant polycystic kidney disease have significant morbidity due to large kidney size. Surgical extirpation of polycystic kidneys is frequently necessary to treat the morbidity or to obtain intraabdominal space for a graft kidney. Simultaneous bilateral nephrectomy and kidney transplantation are performed in many transplant centers to avoid the complications associated with anephric states such as anemia requiring blood transfusion, osteodystrophy, fluid overload, hyperkalemia, and congestive heart failure. However, the risk of postoperative complications after combined bilateral nephrectomy with kidney transplantation is relatively high, especially for cases in which the polycystic kidneys are huge. Here, we report two cases of severe and persistent hypotension during and after combined surgery which may have been caused by adrenal insufficiency or by sympathetic denervation and splanchnic vasculature decompression after the removal of huge polycystic kidneys.

Keyword

Hypotension; Kidney transplantation; Nephrectomy; Polycystic kidney disease

MeSH Terms

Adrenal Insufficiency
Anemia
Blood Transfusion
Decompression
Heart Failure
Humans
Hyperkalemia
Hypotension*
Kidney Failure, Chronic*
Kidney Transplantation*
Kidney*
Nephrectomy*
Polycystic Kidney Diseases*
Polycystic Kidney, Autosomal Dominant
Postoperative Complications
Sympathectomy
Transplants