A 51-year old male
underwent living related renal transplant for ESRD secondary to IgA nephropathy.
His serum creatinine stabilized at 1.8
mg/dL at discharge. On follow-up
visit (day 10 post op), he felt well. He had a urine output of approximately 2
liters of urine/day. He was tolerating his medications well. However, he continued
to have about 700cc of Jackson Pratt (JP) drain output per day. On post op day
14, he developed pain (scale 3-4/10) at the transplant site. His JP drain
output was 90cc two days ago and 0 over the past 24 hours. His serum creatinine
was 2.3 mg/dL (the serum creatinine was 1.8 mg/dL, four days previously). What
do you do next?
A.) Renal ultrasound
B.) MRI with gadolinium
C.) Allograft biopsy
D.) An angiogram using low osmolality contrast agent
E.) Continue to observe closely and ask him to return for
follow-up in 3 days
(Case and Discussion from Dr. Anand Vadivel, Renal Division, and Dr. Sayeed Malek, Renal Transplant Surgery, Brigham and Women's Hospital)
(Case and Discussion from Dr. Anand Vadivel, Renal Division, and Dr. Sayeed Malek, Renal Transplant Surgery, Brigham and Women's Hospital)
