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CONGRESS OF THE ESPU
S6-9 (P without presentation)
VASCULAR THROMBOSIS IN PEDIATRIC KIDNEY
TRANSPLANTATION: ¿CAN WE SAFE THE GRAFT?
Romy GANDER
1
, Marino ASENSIO
1
, Gloria Fatou ROYO
1
, José Andrés MOLINO
1
,
Laura GARCÍA
2
, Alvaro MADRID
3
, Gema ARICETA
3
and Manuel LOPEZ
2
1) Hospital Vall d’Hebron Barcelona, Pediatric Surgery. Pediatric Urology and Renal Transplant Unit, Barcelona,
SPAIN - 2) Hospital Vall d’Hebron Barcelona, Pediatric Surgery, Barcelona, SPAIN - 3) Hospital Vall d’Hebron Barcelona,
Pediatric nephrology, Barcelona, SPAIN
PURPOSE
Vascular thrombosis (VT) in Pediatric kidney transplantation (KT) is a dreaded event and related
to graft loss in almost 100% of cases. Among KT performed in more recent years it has become
the most common cause of early graft loss. The aim ouf our study was to analize our experience in
diagnosis and treatment of VT.
MATERIAL AND METHODS
We conducted a retrospective study of 176 pediatric KT performed at our institution between
January 2000 and December 2015 and identified patients with VT. A protocol of early detection and
prevention of VT was introduced in 2012.
RESULTS
Out of 176 KT, 9 cases of VT were identified (5.1%). Mean recipient age was 5.1 years (SD 4.9)
and mean weight was 22.28 Kg (SD 15.6). Diagnosis was intraoperative in 2 cases and in the
first 24 hours after surgery in the remaining 7. Immediate surgical exploration was performed after
diagnosis in all cases. Of the 5 cases that occurred before 2012, all developed complete graft is-
chemia requiring nephrectomy. In the 4 cases diagnosed after 2012, graft perfusion was recovered
completely in 3 and abdominal wall closure with a mesh and delayed sequentially clousure under
ultrasound guidance was performed. With a follow-up of 20, 15 and 10.5 months respectively, the
3 recovered grafts are functioning normally.
CONCLUSIONS
The application of a protocol for prevention, detection and treatment of VT in pediatric KT can
prevent graft loss. Immediate surgical intervention is mandatory after diagnosis. Avoid compartment
syndrome with delayed sequential clousure is useful to improve graft survival.
S6-10 (P without presentation)
CHILD-FRIENDLY PROTOCOLS FOR ISOTOPE EXAMS
IN PEDIATRIC UROLOGIC INDICATIONS
Christa STRASSER
1
, Bernhard HAID
2
, Nina KUNDTNER
3
, Martin STEINMAYR
4
,
Werner LANGSTEGER
4
, Martin HENKEL
3
and Josef OSWALD
2
1) Krankenhaus der Barmherzigen Schwestern Linz, Paediatric Urology, Linz, AUSTRIA - 2) Krankenhaus der
Barmherzigen Schwestern Linz, Department of Pediatric Urology, Linz, AUSTRIA - 3) Krankenhaus der Barmherzigen
Schwestern Linz, Department of Pediatrics, Linz, AUSTRIA - 4) Krankenhaus der Barmherzigen Schwestern Linz,
Department of Nuclear Medicine, Linz, AUSTRIA
PURPOSE
Radioisotope investigations of the kidney are essential diagnostic tool in paediatric urology. Despite
a variety of publications regarding the technical implementation of these investigations, recom-
mendations concerning child-friendly examination are rare. The aim of this study was to evaluate
isotope investigations with particular regard to the indication for sedation of children.