Korean J Transplant.  2023 Nov;37(Suppl 1):S47. 10.4285/ATW2023.F-6129.

Kidney allograft torsion, a rare post kidney transplantation complication: a case report

• Markum MU
• Marbun MBH
• Susalit E

• KMID: 2551634
• DOI: http://doi.org/10.4285/ATW2023.F-6129

Abstract

Kidney allograft torsion is defined as rotation of allograft around its renal pedicle and a rare complication with high rate of graft loss. The nonspecific presentation and inability to provide definitive diagnosis by imaging in cases of partial torsion may delay the diagnosis and treatment. This is a case of a 43-year-old male with a history of glomerulonephritis and end-stage kidney disease with 2 years history of hemodialysis who received a living related transplant from his sibling in 2017. The transplanted kidney was placed intraperitoneal position with laparoscopic surgery in Palembang. After surgery he never had hemodialysis again. In 2019 he had traffic accident but there was no hospitalitation. About 6 months ago, he had complained weakness and decreasing kidney function with creatinine serum increased and decreased urine output 700 mL in 24 hours. There was a swol-len and moderate hydronephrosis of the allograft kidney in computed tomography scan and resistive index 0.88 in kidney allograft Doppler ultrasonography. Patient will be performed double J stent by urologist but there were difficulties and cannot be done. This patient consulted to Cipto Mangunkusumo Hospital, Jakarta to be evaluated with suspected torsion of the allograft kidney. Acute torsion generally has a prompt onset, and immediate surgery is indicated. Ultrasound can be used to support a diagnosis, often displaying alterations in the renal arterial flow rate and resistive indices. Importantly, in cases of partial or intermittent torsion, symptoms may be episodic and the classic ultrasound findings may be absent.