Status:
Ready to upload
Record number:
2007
Adverse Occurrence type:
MPHO Type:
Estimated frequency:
Very rare. There are 6 cases reported in the literature
Time to detection:
Post-operative days 2 and 3
Alerting signals, symptoms, evidence of occurrence:
Fever within the first 48-72 hours and the presence of renal aneurysms afterwards in both recipients. Blood and urine cultures positive for Pseudomonas aeruginosa.
Demonstration of imputability or root cause:
There is a chance that sepsis and formation of the aneurysms in both recipients were due to sepsis by Pseudomonas aeruginosa transmitted from the donor since the donor had pneumonia with a respiratory sample positive to that microorganism. However, no specific information is given about the similarity of antibiogram or a pulsed-field electrophoresis among the different strains to set up if they were the same. The acquisition of the same infection in both recipients could also have been from another origin such as preservation fluid.
Imputability grade:
2 Probable
Groups audience:
Keywords:
Suggest new keywords:
infectious pseudoaneurysm
Pseudomonas aeruginosa
donor-derived infection
renal transplantation
Reference attachment:
Suggest references:
Berger MF, Badell IR. Single Donor-Derived Pseudomonas aeruginosa Pseudoaneurysms in Two Kidney Transplant Recipients: A Case Report of Dichotomous Allograft Outcomes. Transplant Proc. 2017 Dec;49(10):2357-2361
Expert comments for publication:
Infectious pseudoaneurysms of the renal artery is a known complication, albeit infrequent, in the postoperative period of renal transplantation. Infectious pseudoaneurysms have been typically associated with infection by Candida spp, specially when the preservation fluid is contaminated. One should be in alert when sepsis develops soon after transplant procedure to suspect donor origin and, therefore, to closely monitor evolution of graft vasculature for clues.