Acute XXXX : graft salvage by means of intra-arterial fibrinolysis.

@entity1 @entity715 @entity8 @entity432
BACKGROUND: Arterial @entity715 in a transplanted kidney is a serious complication that usually leads to graft loss. The purpose of our study was to evaluate intra-arterial fibrinolysis as a treatment of @entity8 and to determine the maximum period of occlusion allowing a reasonable chance of graft salvage. METHODS AND RESULTS: Four @entity1 underwent intra-arterial fibrinolysis for acute transplant artery @entity715 . Transplantations had been performed 29 days to 10 years before the fibrinolysis. Fibrinolysis was carried out by using recombitant tissue plasminogen activator (n=1) or urokinase (n=3). In one @entity1 , anuric for 13 hr at admittance, fibrinolysis could not revascularize the graft artery. In a second @entity1 , anuric for 48 hr at admittance, fibrinolysis did revascularize the graft artery, but dialysis could not be discontinued. In the two remaining @entity1 , anuric for 19 and 20 hr at admittance, the graft artery was successfully revascularized and dialysis could be discontinued 1 week later. One of these two @entity1 returned to dialysis 71 months later because of chronic rejection. Thirty-four months after the acute episode, the remaining @entity1 had a patent artery and did not require dialysis. CONCLUSIONS: Fibrinolysis seems an efficient treatment that may save transplants after up to 24 hr of the @entity432 .
