INTRODUCTION: Although rare (incidence of 0,1 to 8.2%), renal vein thrombosis is a major cause o early graft loss. Here we try to identify perioperative risk factors for such a catastrophic event.MATERIALS AND METHODS: We identified all cases of renal vein thrombosis in our kidney transplant database and collected the following data: Type of transplant (live vs. deceased, kidney-pancreas), graft side, presence of renal vein elongation and any special consideration that the surgeon recorded.RESULTS: From February 2010 to December 2014, 3976 consecutive kidney transplants were performed in our institution and 36 renal vein thrombosis were identified (0.9%). The diagnoses were made from postoperative day 1 to day 38 reaching a peak between day 3 and 7. Twenty nine (83,3%) were deceased donors, 5 (13,8 %) living donors and one case of pancreatic-kidney transplant. Regarding kidney side, 58% were left side grafts and 42% right side grafts. Among the right side grafts 59% underwent renal vein elongation. Only in 6 cases (15%) the surgeon reported any unusual condition that could lead thrombosis: 1 poorly perfused graft after unclamping, leading to redo of the anastomosis. 2 Stretched renal vein after positioning the kidney, leading to nephropexy in order to relive the tension on the vein. 3 Ischemic antero inferior segment of the kidney after a unrecognized ligation of polar vein and artery. 4 Reanastomose of the renal vein after compression by the ureter. 5 Severe macroscopic hematuria after unclamping. 6 Vein narrowing after elongation. Moreover only in 2 cases (5.5%) a severe hypotension was identified in the first 24 hours after the procedure.CONCLUSION: Renal vein thrombosis is a rare catastrophic complication, in our large series the incidence was 0.9%. In only 15% of the cases the surgeon perceived a possible factor that could have contributed to such event.

CITATION INFORMATION: Marinho Neto H, Leslie B, Neves Neto J, Offerni J, Pessoa A, Almeida M, Nogueira M, Ximenes S, Aguiar W, Tedesco H, Medina Pestana J. Renal Vein Thrombosis Incidence in 3976 Consecutive Kidney Transplants: Retrospective Analyses Focusing on Intraoperative Risk Factors. Am J Transplant. 2016;16 (suppl 3).

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