Pulmonary embolus originating from renal vein stump thrombus after laparoscopic living donor nephrectomy

Case report

N. Lubezky, E. H. Stern, V. Nair, D. Herron, E. Chin, M. Palese, D. Lapointe Rudow, V. Delaney, M. Goldstein, S. Florman, Juan P. Rocca

Research output: Contribution to journalArticle

Abstract

Background Pulmonary embolism (PE) is an uncommon, life-threatening complication after living donor nephrectomy (LDN), and is considered among the most common causes for donor mortality. Most cases of postoperative PEs are thought to originate in deep venous thrombosis (DVT) of the lower extremities.

Case Report A 56-year-old, healthy woman underwent laparoscopic left LDN. Her postoperative course was complicated by PE, presenting at postoperative day 7. Doppler ultrasonography of her lower extremities did not demonstrate DVT. Both transthoracic echocardiogram and contrast-enhanced computed tomography demonstrated a floating thrombus within the inferior vena cava (IVC) originating from a thrombus in the left renal vein stump. Symptoms resolved with systemic anticoagulation. Repeat transesophageal echocardiography demonstrated resolution of the IVC thrombus.

Conclusions Thrombus originating in left renal vein stump should be considered in patients who develop PE after LDN, especially when lower extremity DVT is not demonstrated.

Original languageEnglish (US)
Pages (from-to)2406-2408
Number of pages3
JournalTransplantation Proceedings
Volume46
Issue number7
DOIs
StatePublished - Sep 1 2014
Externally publishedYes

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Renal Veins
Living Donors
Embolism
Nephrectomy
Thrombosis
Pulmonary Embolism
Venous Thrombosis
Lower Extremity
Lung
Inferior Vena Cava
Doppler Ultrasonography
Transesophageal Echocardiography
Tomography
Tissue Donors
Mortality

ASJC Scopus subject areas

  • Surgery
  • Transplantation

Cite this

Pulmonary embolus originating from renal vein stump thrombus after laparoscopic living donor nephrectomy : Case report. / Lubezky, N.; Stern, E. H.; Nair, V.; Herron, D.; Chin, E.; Palese, M.; Lapointe Rudow, D.; Delaney, V.; Goldstein, M.; Florman, S.; Rocca, Juan P.

In: Transplantation Proceedings, Vol. 46, No. 7, 01.09.2014, p. 2406-2408.

Research output: Contribution to journalArticle

Lubezky, N, Stern, EH, Nair, V, Herron, D, Chin, E, Palese, M, Lapointe Rudow, D, Delaney, V, Goldstein, M, Florman, S & Rocca, JP 2014, 'Pulmonary embolus originating from renal vein stump thrombus after laparoscopic living donor nephrectomy: Case report', Transplantation Proceedings, vol. 46, no. 7, pp. 2406-2408. https://doi.org/10.1016/j.transproceed.2014.01.013
Lubezky, N. ; Stern, E. H. ; Nair, V. ; Herron, D. ; Chin, E. ; Palese, M. ; Lapointe Rudow, D. ; Delaney, V. ; Goldstein, M. ; Florman, S. ; Rocca, Juan P. / Pulmonary embolus originating from renal vein stump thrombus after laparoscopic living donor nephrectomy : Case report. In: Transplantation Proceedings. 2014 ; Vol. 46, No. 7. pp. 2406-2408.
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AU - Stern, E. H.

AU - Nair, V.

AU - Herron, D.

AU - Chin, E.

AU - Palese, M.

AU - Lapointe Rudow, D.

AU - Delaney, V.

AU - Goldstein, M.

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AU - Rocca, Juan P.

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N2 - Background Pulmonary embolism (PE) is an uncommon, life-threatening complication after living donor nephrectomy (LDN), and is considered among the most common causes for donor mortality. Most cases of postoperative PEs are thought to originate in deep venous thrombosis (DVT) of the lower extremities.Case Report A 56-year-old, healthy woman underwent laparoscopic left LDN. Her postoperative course was complicated by PE, presenting at postoperative day 7. Doppler ultrasonography of her lower extremities did not demonstrate DVT. Both transthoracic echocardiogram and contrast-enhanced computed tomography demonstrated a floating thrombus within the inferior vena cava (IVC) originating from a thrombus in the left renal vein stump. Symptoms resolved with systemic anticoagulation. Repeat transesophageal echocardiography demonstrated resolution of the IVC thrombus.Conclusions Thrombus originating in left renal vein stump should be considered in patients who develop PE after LDN, especially when lower extremity DVT is not demonstrated.

AB - Background Pulmonary embolism (PE) is an uncommon, life-threatening complication after living donor nephrectomy (LDN), and is considered among the most common causes for donor mortality. Most cases of postoperative PEs are thought to originate in deep venous thrombosis (DVT) of the lower extremities.Case Report A 56-year-old, healthy woman underwent laparoscopic left LDN. Her postoperative course was complicated by PE, presenting at postoperative day 7. Doppler ultrasonography of her lower extremities did not demonstrate DVT. Both transthoracic echocardiogram and contrast-enhanced computed tomography demonstrated a floating thrombus within the inferior vena cava (IVC) originating from a thrombus in the left renal vein stump. Symptoms resolved with systemic anticoagulation. Repeat transesophageal echocardiography demonstrated resolution of the IVC thrombus.Conclusions Thrombus originating in left renal vein stump should be considered in patients who develop PE after LDN, especially when lower extremity DVT is not demonstrated.

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