A case report of successful preservation of renal graft function using steroid alone as the immunosuppressant for the critical period due to type I acute aortic dissection and hepatic failure after cadaveric renal transplantation

• Published in: Japanese Journal of Transplantation Vol. 48; no. 1; pp. 053 - 057
• Main Authors: KITAJIMA, Toshihiro, MARUI, Yuhji, TANAKA, Kiho, OHASHI, Kenichi, TOMIKAWA, Shinji
• Format: Journal Article
• Language: Japanese
• Published: The Japan Society for Transplantation 10.03.2013
• Subjects: cadaveric renal transplant; type I acute aortic dissection
• ISSN: 0578-7947; 2188-0034
• DOI: 10.11386/jst.48.053

A 43-year-old Japanese male developed type I acute aortic dissection and hepatic failure seven months after cadaveric renal transplant. After an urgent hemi-arch replacement, a cerebral infarction, hepatic failure, and left hemiplegia occurred. Because of the sepsis and hepatic failure, all immunosuppressive agents except for the steroids needed to be withdrawn. One month later, as his physical condition improved, his urine output gradually increased, and a renal graft biopsy was performed to evaluate the graft viability. The pathological findings showed no severe rejection, but there was acute tubular necrosis (ATN), mainly a result of renal circulation insufficiency. Low-dose immunosuppressant treatment was resumed, thus resulting in preservation of the renal graft function.