A 27-year-old female patient with CRE secondary to renal hypoplasia diagnosed at 2 years of age.
At 9 years of age, with CKD stage RV, receives a kidney transplant from a living donor related; presented loss of function of the transplant due to chronic rejection eight years later, requiring admission to a tricyclic hemodialysis plan.
She presented multiple complications due to vascular malformations and infections of the hemodialysis accesses.
He was referred to our institution ten years later due to exhaustion of vascular accesses.
Angiography of the upper and lower limbs and vena cava showed thrombosis of both jugular, subclavian and innominate veins, as well as of both femoral and iliac veins.
Without the possibility of a living related transplant, it was decided to enter it in peritoneal dialysis plan and enter it in an emergency plan to receive a kidney transplant from cadaveric donor.
A peritoneal dialysis catheter is placed, starting this treatment immediately after using a cycling device, achieving a suitable dialysis dose with good tolerance.
Due to the vascular status of the patient, the kidney required recovery of vascular anastomosis leakage, leading to a peritoneal approach and losing the possibility of continuing peritoneal dialysis in the postoperative period of transplantation until the end of dialysis.
This raises the need for a conventional approach at the time of transplantation.
When the cadaveric kidney was available, after the transplant, a catheter was placed in the ovarian vein for hemodialysis.
The right ovarian vein was dissected (dilated by the obstruction of the iliac vein), a tunneled catheter Quinton Permcath® Dual Lumen diameter was placed and a vena cava progressed with 14.5 French suture was made.
Placement was confirmed by radioscopy and subcutaneous tunneling was performed in the abdominal wall.
The procedure was successful.
Anticoagulation with sodium heparin was started 6 hours after surgery.
Forty-eight hours after kidney transplantation he required his first dialysis treatment, which was performed by catheter placed with optimal blood pump flow without complications, allowing dialysis treatment until recovery of transplant function.
