Abstract

ZALTZMAN-GIRSHEVICH, S; SANCHEZ-GARCIA, C; SUAREZ-BARAJAS, EM  and  CORCUERA-DELGADO, CT. Ascites after pediatric renal transplant. Case report. Acta pediatr. Méx [online]. 2016, vol.37, n.6, pp.328-332. ISSN 2395-8235.  https://doi.org/10.18233/apm37no6pp328-332.

The presence of ascites after a renal transplant is an uncommon entity generally caused by complications of the surgical technique. We present a 5 year-old male with diagnosis of chronic glomerulonephritis; who received a kidney transplant of a related live donor, with adequate function of the allograft during the first hours after transplant, developing ascites 72 hours after surgery, with a serum-ascites albumin gradient of 0.92 g/dL. Because of this a surgical intervention was necessary; there was ascites in great amount in the peritoneal cavity and infiltration of liquid in between the surface of the native kidney and its capsule; nephrectomy of this kidney was done. In the histopathological exam severe dilatation of the lymphatic vessels was observed. The patient evolution after the surgery was satisfactory. Chylous ascites is due to the drain of lymph into the peritoneal cavity. In the literature we found some cases of ascites of lymph origin after kidney transplant. According to the findings described; we considered that the ascites was due to lymph transudate from the capsule of the native kidney secondary to obstruction of the lymph vessels due to excessive aortic manipulation during renal transplant surgery. In pediatric patients that have undergone an intraperitoneal renal transplant and develop ascites, the lymphatic origin of this should be consider.

Keywords : chylous ascites; collapsing glomerulonephritis; nephrocalcinosis; kidney transplant; case report.