Mesh Hood Fascial Closure in Renal Allograft Compartment Syndrome

Authors

K. A. Beasley, The University of Western Ontario
Vivian C. McAlister, The University of Western Ontario
P. P. W. Luke, The University of Western Ontario

Document Type

Article

Publication Date

11-2003

Journal

Transplantation Proceedings

Volume

35

Issue

7

First Page

2418

Last Page

2419

URL with Digital Object Identifier

http://dx.doi.org/10.1016/j.transproceed.2003.08.013

Abstract

Renal allograft compartment syndrome (RACS) is an underreported and poorly described surgical complication of renal transplantation. It occurs when a tight fascial closure compresses the graft in its limited retroperitoneal space. Without early recognition and reexploration, graft loss is inevitable. We describe a technique using a polypropylene mesh fascial closure (MHFC) to prevent and treat RACS. MHFC was performed primarily to prevent RACS and secondarily to treat this complication. Between April 2001 and October 2002, 16 patients undergoing 17 renal transplants underwent MHFC. Mean recipient body weight was 17% less than the mean donor weight. Mean follow-up was 9 months. Mean serum creatinine after primary MHFC was 148.4 micromol/L. Three of four patients with RACS regained function following secondary MHFC and had a mean serum creatinine of 155.3 micromol/L. Wound complications were seen in 5 (31%) with no wound or mesh infections and one patient was diagnosed with a lymphocele. We conclude that MHFC can be safely performed after kidney transplantation to prevent or treat RACS.