DONOR-RELATED SECONDARY HEMORRHAGE COMPLICATING RENAL-TRANSPLANTATION

We report two cases of secondary haemorrhage in renal transplant recip ients that would appear to relate to their common donor. Our experienc e confirms the inadequacy of arterial repair in this setting. One pati ent, a middle aged diabetic male, required excision of his external il iac artery, but recovered without reconstructive surgery. In the secon d case nephrectomy was performed on day 8 because of accelerated rejec tion. This was followed by recurrent sepsis due to E. coli, which was implicated in the previous case. Haemorrhage from the donor aortic wal l patch occurred 3 weeks later. We now recommend that if secondary hae morrhage occurs, recipients of other organs from the donor should be c arefully monitored for evidence of infection. If this is found and a s imilar organism cultured, consideration to transplant nephrectomy shou ld be made with removal of all donor tissue to avoid the risk of subse quent secondary haemorrhage.