Graft contrast induced nephropathy caused by pre?renal transplant CT

초록

Pre?transplant evaluation prior to kidney transplant (KT) is not only important for determining candidacy, but also for predicting post?transplant prognosis. However, deceased donors KT, it is difficult to perform pre?transplant tests prior to KT. The patient has been under hemodialysis for eight years and was admitted to the hospital for a KT from a deceased donor. We inserted a tunnel catheter to maintain a line run a cardiac CT and 3D low extremity angio CT to confirm the patient’s cardiac function and iliac artery. After a successful transplantation surgery, The patient showed a urine output of 250ml and a reduction of Cr level from 8.8 to 2.3 on day four following KT. However, urine output suddenly decreased (30ml) and Cr level suddenly increased to 7.6 without any symptoms. The graft biopsy conducted to rule out T?cell mediated rejection indicated CIN, and contrast?enhanced kidney was observed in non?contrast CT that was taken to rule out vessel and other complications immediately following KT. The patient tested negative on subsequent PRA and DSA and discharged a week later with improvement. As shown here, there may be residual contrast from pre?transplant CT that was conducted for health examinations, which could act on the functional graft kidney after transplantation and cause CIN. If it is irreversible, it can induce loss of graft function, calling for precautions while performing CT scans.