Kidney transplantation is the treatment of choice for patients with ESRD. One rare complication after transplantation is the development of renal allograft compartment syndrome (RACS). We present a case of 1 patient who developed RACS due to compression of the transplant vein, which was then treated by salvaging the kidney transplant using urgent decompression surgery with mesh fascial closure. We postulate that this technique is safe and should be the treatment of choice for patients with RACS.

1.
Nieuwenhuijs-Moeke
GJ
,
Pischke
SE
,
Berger
SP
,
Sanders
JSF
,
Pol
RA
,
Struys
MMRF
, et al.
Ischemia and reperfusion injury in kidney transplantation: relevant mechanisms in injury and repair
.
J Clin Med
.
2020
;
9
(
1
):
253
.
2.
Halawa
A
.
Abdominal wall closure of renal transplant recipients: an undermined challenge
.
Int J Organ Transplant Med
.
2010
;
1
(
2
):
73
6
.
3.
Beasley
KA
,
McAlister
VC
,
Luke
PP
.
Mesh hood fascial closure in renal allograft compartment syndrome
.
Transplant Proc
.
2003
;
35
(
7
):
2418
9
.
4.
Nguan
CY
,
Beasley
KA
,
McAlister
VC
,
Luke
PP
.
Treatment of renal transplant complications with a mesh hood fascial closure technique
.
Am J Surg
.
2007
;
193
(
1
):
119
21
.
5.
Ball
CG
,
Kirkpatrick
AW
,
Yilmaz
S
,
Monroy
M
,
Nicolaou
S
,
Salazar
A
.
Renal allograft compartment syndrome: an underappreciated postoperative complication
.
Am J Surg
.
2006
;
191
(
5
):
619
24
.
6.
Heer
MK
,
Trevillian
PR
,
Hardy
DB
,
Hibberd
AD
.
Salvaging kidneys with renal allograft compartment syndrome
.
Transpl Int
.
2012
;
25
(
4
):
e47
9
.
7.
Wood
LN
,
Yang
W
,
Annamalai
A
.
Mesh hood fascial closure is a safe alternative to prevent renal allograft compartment syndrome during kidney transplantation
.
Transplant Proc
.
2015
;
47
(
6
):
1845
9
.
8.
El-Bandar
N
,
Kroy
DC
,
Fuller
TF
,
Kramer
J
,
Liefeldt
L
,
Budde
K
, et al.
Development of graft-site candidiasis in 3 solid organ transplant recipients from the same donor
.
Am J Case Rep
.
2017
;
18
:
777
81
.
9.
Humar
A
,
Sharpe
J
,
Hollomby
D
.
Salvage of a renal allograft with renal vein occlusion secondary to extrinsic compression
.
Am J Kidney Dis
.
1996
;
28
(
4
):
622
3
.
10.
Wiebe
S
,
Kellenberger
CJ
,
Khoury
A
,
Miller
SF
.
Early Doppler changes in a renal transplant patient secondary to abdominal compartment syndrome
.
Pediatr Radiol
.
2004
;
34
(
5
):
432
4
.
11.
Kolofousi
C
,
Stefanidis
K
,
Cokkinos
DD
,
Karakitsos
D
,
Antypa
E
,
Piperopoulos
P
.
Ultrasonographic features of kidney transplants and their complications: an imaging review
.
ISRN Radiol
.
2013
;
2013
:
480862
.
12.
Miah
M
,
Madaan
S
,
Kessel
DJ
,
Newstead
CG
,
Guleria
S
.
Transplant renal artery kinking: a rare cause of early graft dysfunction
.
Nephrol Dial Transplant
.
2004
;
19
(
7
):
1930
1
.
13.
Doty
JM
,
Saggi
BH
,
Sugerman
HJ
,
Blocher
CR
,
Pin
R
,
Fakhry
I
, et al.
Effect of increased renal venous pressure on renal function
.
J Trauma
.
1999
;
47
(
6
):
1000
3
.
14.
Doty
JM
,
Saggi
BH
,
Blocher
CR
,
Fakhry
I
,
Gehr
T
,
Sica
D
, et al.
Effects of increased renal parenchymal pressure on renal function
.
J Trauma
.
2000
;
48
(
5
):
874
7
.
15.
Maione
C
,
Gambino
G
,
Di Bona
A
,
Luna
E
,
Turco
D
,
Scio
A
, et al.
PTFE mesh in renal allograft compartment syndrome
.
Transplant Proc
.
2006
;
38
(
4
):
1049
50
.
16.
Brown
CN
,
Finch
JG
.
Which mesh for hernia repair?
Ann R Coll Surg Engl
.
2010
;
92
(
4
):
272
8
.
17.
Öberg
S
,
Andresen
K
,
Rosenberg
J
.
Absorbable meshes in inguinal hernia surgery: a systematic review and meta-analysis
.
Surg Innov
.
2017
;
24
(
3
):
289
98
.
18.
Huang
Q
,
Li
J
,
Lau
WY
.
Techniques for abdominal wall closure after damage control laparotomy: from temporary abdominal closure to early/delayed fascial closure: a review
.
Gastroenterol Res Pract
.
2016
;
2016
:
2073260
.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.