Trauma to transplanted kidney with open fractures: Report of a case

Abstract

A 45 year-old man, who had undergone kidney transplantation 7 years prior, was admitted to hospital after a motorcycle accident. The patient was conscious, hemodynamically stable, and had suffered open tibia and femur fractures, as well as closed pubic arm fractures. He had gross hematuria and radiologic study revealed a 3.5 cm length laceration on the transplanted kidney. His renal functions and hematuria recovered after intensive care. He required 2 surgeries for the open fractures but his general condition worsened after the surgical interventions. Acinetobacter, Candida albicans and pseudomonas aeruginosa were determined by blood cultures. Immunosupressive drugs (cyclosporine, prednisolone and azathioprine) were stopped. Despite intensive care, the patient died of sepsis 17 days post trauma. Open fractures of long bones provide a higher risk of sepsis in transplant patients than closed fractures. © 2009 Versita Warsaw and Springer-Verlag Berlin Heidelberg.