A case of kidney graft injury during cesarean section in a pancreas and kidney transplantation recipient
Although organ transplantation is becoming general practice, little is known about the safety of delivery. This is the first known case that describes injury to the kidney by the uterine fundal pressure maneuver during cesarean section in a pancreas and kidney transplant recipient. A 40-year-old p...
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| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Fujita Medical Society
2025-02-01
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| Series: | Fujita Medical Journal |
| Subjects: | |
| Online Access: | https://www.jstage.jst.go.jp/article/fmj/11/1/11_2024-008/_pdf/-char/ja |
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| Summary: | Although organ transplantation is becoming general practice, little is known about the safety of delivery. This is the
first known case that describes injury to the kidney by the uterine fundal pressure maneuver during cesarean section
in a pancreas and kidney transplant recipient. A 40-year-old pregnant woman (gravida 0, para 0) was referred to our
clinic. She had undergone living donor kidney transplantation 11 years earlier and brain-dead donor pancreas
transplantation 1 year earlier owing to type 1 diabetes. Cesarean section was indicated when the patient’s blood
pressure was 150/100 mmHg at 37 weeks. We pushed the uterine fundus during delivery of the infant, with our
usual caution. Serum creatinine levels were 1.6–2.6 mg/dl postoperatively. As this elevation was considered to be
due to kidney graft dysfunction, we performed computed tomography, which revealed a hematoma around the
kidney graft. Fifteen days after the cesarean section, surgical removal of the hematoma was performed by the
transplant surgery team. Following hematoma removal, the serum creatinine level decreased to <1.4 mg/dl. We
present a case of kidney graft injury during cesarean section in a pancreas and kidney transplant recipient. |
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| ISSN: | 2189-7247 2189-7255 |