{Reference Type}: Journal Article {Title}: Treatments for pathogen infection rescued 2 patients with renal artery rupture after kidney transplantation: A case report. {Author}: Lian X;Liu S;Zhang J;Pang L;Yi X;Wang G; {Journal}: Medicine (Baltimore) {Volume}: 103 {Issue}: 31 {Year}: 2024 Aug 2 {Factor}: 1.817 {DOI}: 10.1097/MD.0000000000039124 {Abstract}: BACKGROUND: Renal artery rupture due to allograft infection, especially by fungi, is a serious clinical complication that can occur after kidney transplantation, and may lead to graft loss and death.
METHODS: Two kidney recipients from China who developed renal artery rupture at our hospital on 5 days (47-year-old female) and 45 days (39-year-old male) after surgery.
METHODS: The male had immunoglobulin A nephropathy as a primary disease, and experienced a postoperative attack of vascular rejection and mixed infection by Mucor and bacteria. The female had chronic glomerulonephritis as a primary disease, and experienced renal artery rupture near the anastomosis site with infection by fungi and other pathogens.
METHODS: The male received resection of the implanted kidney and antibiotic therapy with intravenous vancomycin (0.5 g, 2 days) and amphotericin B (530 mg in 33 days). The female received replacing the segment of renal arterial and internal iliac artery by saphenous vein, as well as antibiotic therapy with amphotericin B (320 mg in 8 days).
RESULTS: The male was recovered and received a second transplantation, while the female was discharged on postoperative day 19.
CONCLUSIONS: In both patients, prompt surgery and aggressive treatment with an antifungal drug (amphotericin B) and antidrugs led to successful rescue.