Boy with renal failure after renal transplant.

Received Accepted Med Ultrason 2013, Vol. 15, No 1, 76-77 Corresponding author: Aurel Bizo IInd Pediatric Department 3-5 Crisan str, 450008 Cluj-Napoca, Romania Phone: +40264 130 816 E-mail: [email protected] A 16 years old boy with chronic renal failure, chronic dialysis, Alport syndrome, severe renal osteodystrophy, and severe arterial hypertension was admitted in the Clinical Institute of Urology and Kidney Transplant. After the renal transplant a transvesical ureteral stent has been placed for 14 days. Four hours after the catheter was removed diuresis stopped and surgical reintervention was needed to correct a ureteral fistula. Intravenous antibiotic therapy and fluids were administered and the immunosuppressant medication was continued (Ciclosporine, CellCept, Cortisone) in order to prevent transplant rejection. The patient was discharged 28 days after the transplantation with normal renal function. After 3 weeks of favorable outcome the patient was admitted in the Pediatric Clinic presenting acute painless macroscopic hematuria, decrease of diuresis, shivers, and fever (39°C). Laboratory studies revealed high creatinine levels (6 mg/dl) and metabolic acidosis. Urine culture was also performed. The Bdimensional kidney ultrasonography is illustrated in figure 1. Doppler ultrasound detected a permeable vascular anastomosis and renal graft hypovascularization. The outcome was unfavorable with worsening of the renal function and development of sepsis. Therefore explant surgery was necessary. The resected graft is presented in figure 2.