Renal allograft compartment syndrome: is it possible to prevent?

Salvatore Buscemi, Giuseppe Damiano, Attilio Ignazio Lo Monte, Giuseppe Buscemi, Vincenzo Davide Palumbo, Giuseppe Buscemi, Carolina Maione, Gabriele Spinelli, Letizia Carmina, Silvia Ficarella

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Renal allograft compartment syndrome (RACS) is a complication characterized by increased pressure over 15 to 20 mm Hg of the iliac fossa site of transplanted kidney that can lead to a reduction of the blood supply to the graft, resulting in organ ischemia. This study aims to evaluate, through a review of the literature, the incidence, detection, treatment, and possible prevention of RACS. The incidence of this complication, which appears generally in the immediate post-transplantation period, is currently approximately 1% to 2% and is underestimated because of poor nosography for the presence of symptoms common to other post-transplantation complications. Doppler ultrasound is indispensable to evaluate the graft function in the immediate postoperative period and in the following days. The onset of RACS involves a surgical decompression of the graft and the subsequent closure of the abdominal wall with tension-free technique. Several authors agree that only the immediate surgical decompression following an early diagnosis can ensure a recovery of the graft. Early detection of the RACS is the key to preventing the loss of the graft. It is desirable to prevent this syndrome by reducing the discrepancy in weight between donor and recipient by 17%. However the shortage of organs makes such a selection not easy; therefore, in cases at risk for RACS, a close instrumental and clinical monitoring of the patient during post-transplantation recovery is recommended, so a prompt surgical decompression can be performed if RACS is suspected.
Original languageEnglish
Pages (from-to)340-343
Number of pages4
JournalTransplantation Proceedings
Volume48
Publication statusPublished - 2016

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Compartment Syndromes
Allografts
Kidney
Surgical Decompression
Transplants
Transplantation
Doppler Ultrasonography
Incidence
Physiologic Monitoring
Abdominal Wall
Postoperative Period
Early Diagnosis
Ischemia
Pressure
Weights and Measures

All Science Journal Classification (ASJC) codes

  • Surgery
  • Transplantation

Cite this

Renal allograft compartment syndrome: is it possible to prevent? / Buscemi, Salvatore; Damiano, Giuseppe; Lo Monte, Attilio Ignazio; Buscemi, Giuseppe; Palumbo, Vincenzo Davide; Buscemi, Giuseppe; Maione, Carolina; Spinelli, Gabriele; Carmina, Letizia; Ficarella, Silvia.

In: Transplantation Proceedings, Vol. 48, 2016, p. 340-343.

Research output: Contribution to journalArticle

Buscemi, Salvatore ; Damiano, Giuseppe ; Lo Monte, Attilio Ignazio ; Buscemi, Giuseppe ; Palumbo, Vincenzo Davide ; Buscemi, Giuseppe ; Maione, Carolina ; Spinelli, Gabriele ; Carmina, Letizia ; Ficarella, Silvia. / Renal allograft compartment syndrome: is it possible to prevent?. In: Transplantation Proceedings. 2016 ; Vol. 48. pp. 340-343.
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abstract = "Renal allograft compartment syndrome (RACS) is a complication characterized by increased pressure over 15 to 20 mm Hg of the iliac fossa site of transplanted kidney that can lead to a reduction of the blood supply to the graft, resulting in organ ischemia. This study aims to evaluate, through a review of the literature, the incidence, detection, treatment, and possible prevention of RACS. The incidence of this complication, which appears generally in the immediate post-transplantation period, is currently approximately 1{\%} to 2{\%} and is underestimated because of poor nosography for the presence of symptoms common to other post-transplantation complications. Doppler ultrasound is indispensable to evaluate the graft function in the immediate postoperative period and in the following days. The onset of RACS involves a surgical decompression of the graft and the subsequent closure of the abdominal wall with tension-free technique. Several authors agree that only the immediate surgical decompression following an early diagnosis can ensure a recovery of the graft. Early detection of the RACS is the key to preventing the loss of the graft. It is desirable to prevent this syndrome by reducing the discrepancy in weight between donor and recipient by 17{\%}. However the shortage of organs makes such a selection not easy; therefore, in cases at risk for RACS, a close instrumental and clinical monitoring of the patient during post-transplantation recovery is recommended, so a prompt surgical decompression can be performed if RACS is suspected.",
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AU - Lo Monte, Attilio Ignazio

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AU - Palumbo, Vincenzo Davide

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